Introduction and Background: Cirrhosis named by Laennec in 1826 means orange or twany in Greek. Cirrhosis is defined by the World Health Organization (WHO) as a diffuse process characterized by fibrosis and the conversion of normal liver architecture into structurally abnormal nodules. (Anthony PP) Patients with cirrhosis are susceptible to a variety of complications, and their life expectancy is markedly reduced. Global liver cirrhosis deaths increased from around 676,000 in 1980 to over 1 million in 2010. Similarly in India also cirrhosis related deaths increased from around 77,741 in 1980 to over 188,575 in 2010. This accounts for almost one-fifth (18.3%) of the global liver cirrhosis death toll. Cirrhosis mortality has been steadily …show more content…
Predictive scoring systems derive a severity score from a variety of clinical variables, to quantify the severity of illness and to predict clinical outcome, usually mortality. Several scoring systems have been developed, like Acute Physiologic and Chronic Health Evaluation (APACHE) system, Simplified Acute Physiologic Score (SAPS), Mortality Prediction Model (MPM), and Sequential Organ Failure Assessment score (SOFA). The APACHE II scoring system is widely used and to be calculated within 24 hours of hospital admission. Child-Turcotte-Pugh (CTP) score and the Model for End-stage Liver Disease (MELD) score are the disease specific scores commonly used for prognosis in cirrhotic …show more content…
It is calculated according to the following formula: MELD = 3.8[Ln serum bilirubin (mg/dl)] + 11.2[Ln INR] + 9.6[Ln serum creatinine (mg/dl)] + 6.4, where Ln is the natural logarithm. The main use of the MELD score is in prioritizing patients on the waitlist for deceased donor liver transplantation based on liver disease severity and short-term mortality risk. MELD score does have its own limitations. The MELD score is subject to variability of laboratory measurements (such as bilirubin and creatinine levels), certain clinically important prognostic information, such as complications of portal hypertension, hepatoma, hepatopulmonary syndrome, and presence of select systemic metabolic disorders such as hyponatremia are not accounted for in the MELD score. Also, the MELD score was developed in a homogeneous cohort of patients waiting for liver transplantation and thus may not be applicable to a cohort of patients who are not being considered for liver transplantation because of either medical or socioeconomic reasons. The group that originally described MELD in a recent review did acknowledge that “MELD is by no means a perfect system”. (Ghoshal
Decompensated cirrhosis is characterized by the development of a cirrhosis-related complication, including variceal hemorrhage, ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, and/or coagulopathies. For patients with compensated and decompensated cirrhosis, the risk of death is 4.7 and 9.7 times higher than the general population, respectively.4 Survival in patients with decompensated cirrhosis is considerably lower than that of patients with compensated cirrhosis. The median survival times are as low as 2 years in decompensated patients and greater than 12 years in compensated
Portal hypertension is usually estimated by the hepatic venous pressure gradient (HVPG). Normally, HVPG ranges from 3 to 5 mmHg. In the compensated stage of cirrhosis, patients initially have moderate portal hypertension (>6 to <10 mmHg) with a low risk of decompensation. However, as portal hypertension progresses to clinically significant levels (HVPG of ≥10 mmHg), the risk for developing decompensated cirrhosis increases. Portal hypertension is a key driver of many of the clinical consequences of cirrhosis (Berzigotti et al., 2013).
In the case study, the patient with alcoholic cirrhosis appears to have a complacent attitude toward abstinence (Butts & Rice, 2012). Even with abstinence, alcoholic cirrhosis has poor prognosis and quality of life, increased risk of infection, and poor long-term outcome after transplantation (Balthasar et al, 2009). It would not be prudent to give such a precious resource to an individual whose abusive habits/ lifestyle brought about their demise with no commitment to sobriety.
Emotional intelligence or EQ is as important as intellectual intelligence because it helps a person understand themselves emotionally. An emotionally intelligent person can control how they deal with stress, which, consequently helps to become successful in several areas of life, such as work, relationships, and career. EQ helps you become aware of yourself mentally and to understand others socially. It impacts all of your life daily, from getting things done to helping friends and family or yourself emotionally. It also helps with being able to understand others and manipulate them for your gain, to get their trust and friendship to form healthy relationships.
The primary consideration of scheduled assessments was the one-year survival rate of participants. Secondary considerations included nutritional, biological, and hepatic parameters, the emergence of complications, and the number of days spent in acute care during the observational period. Data collected through
This case study is about Abdul Chidiac, a 51 year old male, married with 4 children. He had a medical history of hypertension, hypercholesterolaemia and cirrhosis with two admissions in the last six months. He is a smoker and drinks beer, 5-6 bottles per day. As Carithers & McClain (2010) explained the patient’s medical history is another indicator of the risk for cirrhosis; the progression to cirrhosis is adaptable and may take time over weeks or many years. Cirrhosis is a liver disease characterized by permanent scarring of the
In the presented case scenario, we have Mr. Gil Martin who is a 55-year-old Hispanic male. He comes in to the clinic today with complaints of weakness, fatigue, and loss of appetite. A student nurse will be precepting your assessment of Mr. Martin and when collecting subjective and objective data it is important to pay close detail to all findings. Ultimately this patient was diagnosis with cirrhosis, which is an abnormal liver condition that leads to irreversible scarring of the liver (National Institute of Health [NIH], 2017), so during assessment we should pay attention to details leading to this diagnosis.
According to the American Liver Foundation, a healthy liver cleans blood, fights infection processes food and stores energy. The liver is able to regenerate itself, but when it becomes too damaged or is prevented from regenerating, it will fail and no longer be able to keep able to keep one alive (2015). Despite its ability to regenerate, chronic liver disease and cirrhosis is the twelfth leading cause of death of death in the United States. My interest in further exploring liver related deaths is the due to the impact that liver disease has had on my family. My young cousin was born with a malignant tumor on her liver and spent the first several years of her life undergoing surgeries and chemotherapy. She survived the treatment and at the age of 4 was free of cancer. At the age of 24 she was told that her liver was beginning the process of failure and she would need to be put on the transplant liver for long-term survival. My grandmother died of cirrhosis of the liver and my father, after 3 years of treatment for melanoma, was diagnosed with liver failure. He had a procedure to prolong the useful life of his liver, but the damage to his liver will not allow his liver to regenerate and it will likely be liver failure which leads to his death.
In summary, is there is a relationship between developing Hepatitis B&C and HCC? If so, to what extent and whether the patients develop cirrhosis first. Thus, the goal of this study is to assess the current degree of coalition between Hepatitis B&C and Hepatocellular Carcinoma in addition to determine the involvement of Hepatitis induced Cirrhosis in the sample and its effect on Developing
Liver cirrhosis is a life threatening disease and is irreversible. It is therefore of utmost
Has one ever imagined what the world would be like without any arguing? The poems “Six Men and an Elephant” and “The Red and Blue Coat,” include people that argue and fight. The characters have many things that are similar and different. They are similar in the actions of the characters and the lessons learned, but different in the change of the characters. Therefore, the two folk tales share many similarities and differences.
According to the Mayo Clinic Staff, cirrhosis is a late stage of scarring (fibrosis) or damage of the liver. Once the liver is injured it tries to restore itself. Once restored, it forms scar tissue. The more scar tissue formed, the harder it becomes for the liver to function. Cirrhosis is irreversible and there are different causes of cirrhosis, such alcoholic abuse, viral hepatitis or cryptogenic cirrhosis—this occurs when doctors are unable to find the cause of the condition. If diagnosed and treated early, the damage would be limited. In its advanced
The number one preventive measure of liver cirrhosis is to stop drinking alcoholic beverages. Abstinence from alcohol may be difficult for many alcoholics to do, but the result is beneficial for them. Ninety percent of the people with liver cirrhosis who stopped drinking alcohol lives another 5 years, and only seventy percent chance of living less than five years if they continue to drink alcohol (Penny, 2013). According to Leaper and Hamlin, “liver cirrhosis affects protein metabolism and the ability of the liver to store glycogen, which is required for energy (2011). Therefore, people who have cirrhosis are advised to eat foods high in protein and carbohydrates to maintain body’s functions. Limiting protein intake can cause malnutrition or
Additionally, many chronic liver diseases can lead to cirrhosis. For example, nonalcoholic fatty liver disease (NAFLD) can lead to cirrhosis and is associated with obesity, hyperlipidemia, metabolic syndrome and type 2 diabetes mellitus. Hereditary metabolic disorders such as hemochromatosis and Wilson disease can also lead to cirrhosis (McCance & Heuther, 2014). It seems the cause of cirrhosis is multifaceted. Additionally, many diseases can lead to cirrhosis and it is understandable why the etiology of cirrhosis has not been parsed out, especially because the cause can differ from a
Even though the liver has the ability to react to damage and can repair itself, repetitive insults can produce liver failure or deadly diseases, infections, and disorders. A few such diseases are viral hepatitis, yellow fever, and rubella. Some of the disease caused by bacteria are amebic dysentery, leptospirosis, and streptococcal infections. These diseases can fatally damage the liver.