Perfil dos pacientes cirróticos alcoólicos e não alcoólicos admitidos em hospital de referência: análise epidemiológica, gravidades e suporte social
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Tipo
TCC
Data de publicação
2023-11-27
Periódico
Citações (Scopus)
Autores
Gomes, Felipe Rangel Godinho
Ramos, Lorena Aparecida Castagnoli
Ramos, Lorena Aparecida Castagnoli
Orientador
Junior, Carlos Roberto Naufel
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Introdução: A cirrose hepática é uma doença parenquimatosa caracterizada pela presença de necrose e fibrose no tecido hepático, com consequente perda de função do órgão, sendo uma doença crônica com diversas etiologias, com classificação entre cirrose alcoólica e não alcoólica. Infere-se que os fatores epidemiológicos dos pacientes, como sexo, idade, raça, condições e hábitos de vida, história familiar, origem social e localização geográfica, se comuniquem de diferentes formas com as etiologias listadas e estas etiologias, com o quadro clínico, prognóstico e a continuidade frente ao tratamento por parte dos doentes além do apoio familiar, que é central para auxílio neste tratamento. Objetivos: Avaliar o perfil epidemiológico, quadro clínico, prognóstico, suporte familiar, conduta e continuidade ao tratamento por parte dos pacientes com cirrose hepática e relacionar com suas etiologias, alcoólica e não alcoólica. Métodos: Estudo observacional descritivo, prospectivo e transversal. Selecionados os pacientes com doença hepática e que concordem em participar da pesquisa e assinar o TCLE. Aplicação de questionário de avaliação de suporte social percebido por meio da escala de MSPSS, avaliação de prontuários em busca de dados epidemiológicos, clínicos e condutas, aplicação de dados na escala de MELD para avaliação de prognóstico, e acompanhamento dos pacientes até consulta de retorno para avaliação da continuidade ao tratamento. Resultados: Foram estudados 54 pacientes, 29 com o diagnóstico de etiologia alcoólica (53,7%) e 25 com o de etiologia não alcoólica (46,2%). Após a análise de ambos os grupos, observou-se a predominância da etiologia alcoólica e do sexo masculino (p = 0,0029). Quanto as comorbidades associadas, a tireoideopatia foi encontrada somente no grupo de etiologia não alcoólica (p = 0,04) e a ascite foi o único sintoma com diferença estatística entre os grupos, com maior prevalência no de origem alcoólica (p= 0,0014). Também foram encontradas diferenças quanto a presença de circulação colateral nos laudos das tomografias computadorizadas, que se fez mais presente no grupo de causa não alcoólica (p = 0,00001), nos exames laboratoriais de hemoglobina de entrada, os números foram menores no grupo de causa alcoólica (p= 0,053) e em alguns parâmetros da escala MSPSS. A escala de MELD não apresentou diferenças significativas entre as etiologias analisadas. Conclusão: Na amostra estudada, foram encontradas diferenças estatísticas significativas em relação à causa da doença, sexo, comorbidades associadas, ao sintoma de entrada dos pacientes, além de um dos parâmetros dos avaliados na tomografia computadorizada, a presença de circulação, e nos exames laboratoriais de hemoglobina de entrada. Quanto as escalas aplicadas, foram encontradas diferenças estatísticas somente na escala de MSPSS.
Introduction: Liver cirrhosis is a parenchymal disease characterized by the presence of necrosis and fibrosis in the liver tissue, with consequent loss of organ function, being a chronic disease with different etiologies, classified between alcoholic and non-alcoholic cirrhosis. It is inferred that the patients' epidemiological factors, such as sex, age, race, living conditions and habits, family history, social origin and geographic location, communicate in different ways with the listed etiologies and these, with the clinical picture, prognosis and continuity of treatment on the part of patients in addition to family support, which is central to assistance in this treatment. Objectives: To evaluate the epidemiological profile, clinical picture, prognosis, family support, conduct and continuity of treatment for patients with liver cirrhosis and relate it to its etiologies, alcoholic and non-alcoholic. Methods: Descriptive, prospective and cross-sectional observational study. Patients with liver disease who agree to participate in the research and sign the informed consent form are selected. Application of a questionnaire to evaluate perceived social support using the MSPSS scale, evaluation of medical records in search of epidemiological, clinical and behavioral data, application of MELD scale to evaluate prognosis, and monitoring of patients until first appointment for assessment of continuity of treatment. Results: 54 patients were studied, 29 diagnosed with alcoholic etiology (53.7%) and 25 with non-alcoholic etiology (46.2%). After analyzing both groups, a predominance of alcoholic etiology and male gender was observed (p = 0.0029). Regarding associated comorbidities, thyroidopathy was found only in the non-alcoholic etiology group (p = 0.04) and ascites was the only symptom with a statistical difference between the groups, with a higher prevalence in the alcoholic group (p = 0.0014 ). Differences were also found regarding the presence of collateral circulation in the computed tomography reports, which was more present in the non-alcoholic cause group (p = 0.00001), in laboratory hemoglobin tests at entry, which was lower in the non-alcoholic cause group alcohol (p= 0.053) and in some parameters of the MSPSS scale. The MELD scale did not show significant differences between the causes analyzed. Conclusion: In the studied sample, significant statistical differences were found in relation to the cause of the disease, sex, associated comorbidities, the patients admission symptom, in addition to one of the parameters evaluated in the computed tomography, the presence of circulation, and in laboratory tests of incoming hemoglobin. Regarding the scales applied, statistical differences were found only in the some questions in MSPSS scale.
Introduction: Liver cirrhosis is a parenchymal disease characterized by the presence of necrosis and fibrosis in the liver tissue, with consequent loss of organ function, being a chronic disease with different etiologies, classified between alcoholic and non-alcoholic cirrhosis. It is inferred that the patients' epidemiological factors, such as sex, age, race, living conditions and habits, family history, social origin and geographic location, communicate in different ways with the listed etiologies and these, with the clinical picture, prognosis and continuity of treatment on the part of patients in addition to family support, which is central to assistance in this treatment. Objectives: To evaluate the epidemiological profile, clinical picture, prognosis, family support, conduct and continuity of treatment for patients with liver cirrhosis and relate it to its etiologies, alcoholic and non-alcoholic. Methods: Descriptive, prospective and cross-sectional observational study. Patients with liver disease who agree to participate in the research and sign the informed consent form are selected. Application of a questionnaire to evaluate perceived social support using the MSPSS scale, evaluation of medical records in search of epidemiological, clinical and behavioral data, application of MELD scale to evaluate prognosis, and monitoring of patients until first appointment for assessment of continuity of treatment. Results: 54 patients were studied, 29 diagnosed with alcoholic etiology (53.7%) and 25 with non-alcoholic etiology (46.2%). After analyzing both groups, a predominance of alcoholic etiology and male gender was observed (p = 0.0029). Regarding associated comorbidities, thyroidopathy was found only in the non-alcoholic etiology group (p = 0.04) and ascites was the only symptom with a statistical difference between the groups, with a higher prevalence in the alcoholic group (p = 0.0014 ). Differences were also found regarding the presence of collateral circulation in the computed tomography reports, which was more present in the non-alcoholic cause group (p = 0.00001), in laboratory hemoglobin tests at entry, which was lower in the non-alcoholic cause group alcohol (p= 0.053) and in some parameters of the MSPSS scale. The MELD scale did not show significant differences between the causes analyzed. Conclusion: In the studied sample, significant statistical differences were found in relation to the cause of the disease, sex, associated comorbidities, the patients admission symptom, in addition to one of the parameters evaluated in the computed tomography, the presence of circulation, and in laboratory tests of incoming hemoglobin. Regarding the scales applied, statistical differences were found only in the some questions in MSPSS scale.
Descrição
Palavras-chave
cirrose hepática , alcoolismo , cirrose hepática alcoólica , liver cirrhosis , alcoholism , alcoholic liver cirrhosis