Prognostic Implications of Ascites with Hyponatremia in Cirrhosis: A Focus on Patient Demographics and Treatment Outcomes in Bangladesh
Prognostic Implications of Ascites with Hyponatremia in Cirrhosis
Keywords:
Cirrhosis, Ascites, Hyponatremia, Complications, Prognosis, Treatment OutcomesAbstract
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Introduction: Cirrhosis is a chronic liver disease commonly associated with complications, with ascites being the most frequent. Hyponatremia, an electrolyte imbalance, often complicates ascites and worsens outcomes in cirrhotic patients. This study aimed to compare clinical features, complications, and treatment outcomes between ascites with hyponatremia and ascites-only groups in cirrhotic patients. Materials and Methods: A retrospective cohort study was conducted from January 2013 to January 2014 at Sher-E-Bangla Medical College Hospital, Barisal, Bangladesh. The study involved 300 patients diagnosed with cirrhosis and ascites, divided into two groups: the ascites with hyponatremia group (n = 146) and the ascites-only group (n = 154). Data were collected from hospital records, including demographic features, serum sodium levels, complications, treatment regimens, and prognostic outcomes. Statistical analyses were performed using SPSS, with p-values < 0.05 considered significant. Results: The ascites with hyponatremia group had a significantly higher proportion of males (68.5%) compared to the ascites-only group (51.9%) (p = 0.047). The ascites with hyponatremia group also had a significantly longer average hospital stay (11.7 ± 5.3 days vs. 10.2 ± 4.4 days, p = 0.013). Hyponatremia was associated with severe hyponatremia (serum sodium: 126.5 ± 4.5 mmol/L vs. 137.8 ± 2.5 mmol/L, p < 0.001). Significant complications such as hepatic encephalopathy (56.2% vs. 39.0%, p = 0.024), renal impairment (45.2% vs. 28.6%, p = 0.038), and infection (37.0% vs. 23.4%, p = 0.048) were more prevalent in the ascites with hyponatremia group. The logistic regression analysis revealed older age as a significant predictor of complications (OR = 1.06, p = 0.025). Conclusion: Hyponatremia in cirrhosis worsens complications, extends hospital stays, and negatively impacts prognosis. Early detection and targeted management are essential for improving outcomes, highlighting the need to address hyponatremia in the treatment of cirrhotic ascites to enhance quality of life and reduce mortality.
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