Nisar Hussain Shah, Muhammad Umar, Faiz Anwar, Osama Ishtiaq, Kaukab Bashir.
Association of Child-Pugh Class with Patterns of Mortality in Hepatitis C Virus Related Chronic Liver Disease.
J Rawal Med Coll Jan ;5(2):65-7.

Background: To see patterns of mortality in association with Child-Pugh Class in patients with hepatitis C related chronic liver disease. Methods: Fifty patients admitted in medical wards with chronic liver disease and expired in same hospitalization were enrolled in a descriptive design. They were assigned Child Pugh class based on past record and then on fresh data. Cause of death was established and results analysed using descriptive statistics. Results: Fifty patients comprised of 72% (n=36) males and 28°% (n=14) females. Average age was 50±13.8 years. Average duration between diagnosis and death was 8 years. 20%, (n=10, all males) patients presented first time with decompensation and expired during same admission. Two percent (n=1) patients expired in Child-Pugh Class A, 30% (n=18) 10 males & 5 females) in B and 68%, (n=34, 26 males & 9 females) in Child-Pugh Class C. 54% (n=27) patients expired due to upper GI bleed, 40%, (n=20) patients due to sepsis and 6%, (n=3) with other causes. Sepsis was slightly more common in Child B but the difference was not significant (p>0.5), while in upper GI bleed in Child-Pugh Class C it was significant (p<0.001). Conclusion: We concluded that a significant number of patients present first time with decompensated liver disease and a similar proportion is not aware of the disease till late. Mortality in liver disease is related to advanced Child-Pugh class. Most patients who died because of upper GI bleed were in Child class C. Upper GI bleed is the single most common cause of mortality in advanced disease.

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