EVALUATION OF UPPER GASTROINTESTINAL ENDOSCOPIC FINDINGS IN PATIENTS WITH LIVER CIRRHOSIS AT THE KOMFO ANOKYE TEACHING HOSPITAL, GHANA

dc.contributor.authorOPPONG, BRIGHT
dc.date.accessioned2025-01-27T12:32:40Z
dc.date.available2025-01-27T12:32:40Z
dc.date.issued2022-09-01
dc.description.abstractIntroduction: Liver cirrhosis remains an important cause of hospitalization, morbidity, and mortality in sub-Saharan Africa. A common complication of liver cirrhosis is acute upper gastrointestinal bleeding. The objective of this study was to assess the prevalence of upper gastrointestinal endoscopic findings and to correlate the presence of these findings with the severity of liver cirrhosis in patients at the Medicine Directorate, Komfo Anokye Teaching Hospital (KATH). Methods: This was a descriptive cross-sectional study of patients accessing care at the KATH. Consecutive sampling was used to recruit patients with cirrhosis of the liver, diagnosed by transabdominal ultrasound scan. A structured questionnaire was administered to assess socio-demographic characteristics and clinical information. Liver chemistry, full blood count, HBsAg, anti-HCV antibodies and INR tests were done for all the patients. An upper gastrointestinal tract endoscopy was performed for all patients and the severity of the cirrhosis was assessed using the Child-Turcotte-Pugh score. Data was collected with the REDcap tool and exported to STATA statistical software for analysis. Descriptive analysis was performed by using frequencies, percentages and means. Chi-square and Fisher exact tests were used to determine the association between severity of cirrhosis and other predictor variables. Logistic regression and partial proportional odds assumption model were used to determine the odds ratio and possible factors that influenced the severity of cirrhosis. Results: The study included 145 participants. The mean age (standard deviation) of participants was 46.5 ± 12.0. the ratio of males to females was 3:1. Seventy percent had oesophageal varices and 46.2% and 47.6% had portal hypertensive gastropathy and gastritis respectively. Other lesions were gastric ulcer (23.5%) and duodenal ulcer (10.3%). Seventy five percent had hepatitis B infection. Majority of the participants (76.5%) had class C disease and Helicobacter. Pylori (H. pylori) was detected in 87.6%. The presence of oesophageal varices and lax Lower Oesophageal Sphincter (LES) correlated positively with severity of the liver cirrhosis. Oesophageal varices was strongly associated with patients who had finger clubbing (p-value, <0.001), leukonychia (p-value, <0.001), silky hair(p-value, <0.001),, ascites(p-value, <0.036),, palmar erythema(p-value, <0.001),, and spider naevi(p-value, <0.003), Conclusion: Hepatitis B infection is the leading cause of liver cirrhosis at KATH. The most prevalent endoscopic finding was oesophageal varices (mostly medium and large varices) but a significant number of participants had non-variceal lesions. H. pylori infection is common in this population. Screening endoscopy is recommended in cirrhosis to detect lesions which can predispose to upper GIT bleeding.
dc.description.sponsorshipMOH
dc.identifier.urihttps://repository.gcps.edu.gh/handle/123456789/29
dc.language.isoen
dc.publisherOPPONG, BRIGHT
dc.subjectLiver cirrhosis
dc.subjectHospitalization Morbidity
dc.subjectMortality
dc.subjectSub-Saharan Africa Acute upper gastrointestinal bleeding
dc.subjectUpper gastrointestinal endoscopy
dc.subjectSeverity of liver cirrhosis
dc.subjectKomfo Anokye Teaching Hospital (KATH)
dc.subjectDescriptive cross-sectional study
dc.subjectTransabdominal ultrasound scan
dc.subjectSocio-demographic characteristics
dc.subjectClinical information
dc.subjectLiver chemistry
dc.subjectFull blood count
dc.subjectHBsAg
dc.subjectAnti-HCV antibodies
dc.subjectINR tests
dc.subjectChild-Turcotte-Pugh score
dc.subjectREDcap tool
dc.subjectSTATA statistical software
dc.subjectChi-square test
dc.subjectFisher exact test
dc.subjectLogistic regression
dc.subjectPartial proportional odds assumption model
dc.subjectOesophageal varices
dc.subjectPortal hypertensive gastropathy
dc.subjectGastritis
dc.subjectGastric ulcer
dc.subjectDuodenal ulcer
dc.subjectHepatitis B infection
dc.subjectClass C disease
dc.subjectHelicobacter pylori (H. pylori)
dc.subjectFinger clubbing
dc.subjectLeukonychia
dc.subjectSilky hair
dc.subjectAscites
dc.subjectPalmar erythema
dc.subjectSpider naevi
dc.subjectScreening endoscopy
dc.subjectUpper GIT bleeding
dc.titleEVALUATION OF UPPER GASTROINTESTINAL ENDOSCOPIC FINDINGS IN PATIENTS WITH LIVER CIRRHOSIS AT THE KOMFO ANOKYE TEACHING HOSPITAL, GHANA

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