A Study on Patterns and Predictors of Ascites Outcomes in a Tertiary Healthcare Setting

Background

Ascites is the accumulation of abdominal fluid in the peritoneal cavity. Liver cirrhosis, Alcoholic liver disease, Intra-abdominal malignancy, and tuberculosis are the significant etiologies of ascites. In our context, the etiology behind ascites and its correlation with symptoms and complications have not yet been studied, so the present study is conceptualized to evaluate the clinical profile of ascites. The present study aimed to observe the prevalence, clinical management, and assessment of complications associated with ascites in hospitalized patients, offering insights into contemporary ascites management and outcomes.

Materials and Methods

A prospective observational study was conducted at a tertiary care hospital in Hyderabad, and over 6 months of study was conducted on 113 patients admitted with ascites. All patients who fulfilled the inclusion criteria of patients above 18 years and ascites confirmed by clinical and ultrasound examination were thoroughly evaluated with a detailed history, physical examination, and appropriate investigations.

Results

The predominantly male (83%) patient population exhibited liver cirrhosis (27%) as the primary cause, followed by alcoholic liver disease (23%) and portal hypertension (17%). Abdominal distension (24%) and hepatic encephalopathy (35%) were prevalent symptoms. Laboratory analysis revealed transudative ascitic fluid in most cases (10% with SAAG values >1.1 mg/dL), prevalent hyponatremia (up to 50% in cirrhosis and ascites patients), hyperkalemia (1.6%) and anaemia (7%). Management primarily involved diuretics (23%) and human albumin transfusions (19%).

Conclusion

The study highlights early detection and comprehensive management, including liver transplantation consideration for eligible patients, as pivotal for improved outcomes and reduced morbidity and mortality. Emphasizing a multidisciplinary approach, this study underscores the necessity of vigilant monitoring, appropriate fluid handling, and collaborative efforts among medical specialties in ascites management.