ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ CÁC YẾU TỐ LIÊN QUAN ĐẾN TỬ VONG TRONG TUẦN ĐẦU NHẬP VIỆN Ở BỆNH NHÂN XƠ GAN MẤT BÙ DO VIÊM GAN VIRUS B ĐIỀU TRỊ TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI TRUNG ƯƠNG

Abstract

A cross-sectional descriptive study on 149 patients with decompensated cirrhosis due to hepatitis B treated at the National Hospital of Tropical Diseases in the period 2020-2023 to describe the clinical and paraclinical manifestations and to evaluate some factors related to  mortality in the first week after hospitalization of these patients. Results: The main clinical symptoms were fatigue (96.6%), anorexia (91.3%), jaundice (88.6%), ascites (56.4%), edema (43.6%). There are 15.1% of patients with hepatic coma. Main paraclinical changes include HBV-DNA ≥ 10⁶ copies/ml (41.5%), blood albumin  <28g/l (54.4%), the rate of of increase in AST, ALT and total Bilirubin more than 10 times compaired to normal values ​​are 29.5%; 24.8% and 53%, respectively. The average MELD-Na score at the time of hospitalization in the group that died within the first 7 days after admission was statistically significantly higher than in the group that survived. The cutoff point with the best diagnostic value in predicting early death within 7 days of MELD Na is 29 points, with an area under the curve of 0.7; sensitivity and specificity was 72.7% and 63.8%. Conclusion: High MELD-Na score is associated with mortality in the first 7 days after hospitalization for patients with decompensated cirrhosis due to hepatitis B virus, however the mortality prognostic value of MELD-Na is weak, so studies with larger sample sizes are needed to conduct for concluding the role of MELD-Na.