An audit of hepatobiliary diseases in a tertiary level intensive care unit in Nepal

Authors

DOI:

https://doi.org/10.3126/jsan.v4i1.17445

Keywords:

Clinical Audit, Intensive care unit, Liver diseases, Mortality, Prevalence

Abstract

Background: Hepatobiliary diseases account for significant proportion of admission in our intensive care unit, a semi-closed, 11 bedded mixed medical-surgical unit. This study was conducted to study the profile of patients with various hepatobiliary diseases who required intensive care unit admissions with the aim of identifying the need for a hepatobiliary critical care facility. 

Methods: A retrospective study was designed and all consecutive patients admitted with hepatobiliary problems from January 2013 till December 2013 were enrolled in the study.

Results: Out of 467 patients admitted, there were 61 (13.06%) patients with hepatobiliary diseases. Out of 61 patients, there were 24 (39.3%) patients with medical cause for hepatobiliary disease and 37 (60.7%) patients with a surgical cause. The majority of the patients 52.45% were male. The overall mortality in these patients was 37.70%. The mortality in patients with surgical cause for the hepatobiliary disease was less (27.02%). Encephalopathy was a common condition leading to ICU admission. The common medical conditions were Cirrhosis secondary to Alcoholic Liver disease and Acute Fulminant Hepatic Failure. The commonest surgical conditions were Severe Pancreatitis, Post-Whipple's surgery, postoperative sepsis after Cholecystectomy, Liver Injury secondary to Road Traffic Accidents and Severe Cholangitis.

Conclusion: The number of patients presenting to our multidisciplinary unit with hepatobiliary diseases is high and this group of patients have a high mortality. Though the numbers do not suggest an immediate need for a Hepatobiliary intensive care unit, the increasing trend suggests such a facility would be the need of time in near future.

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Author Biographies

Pramesh Sunder Shrestha, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu 44600

Lecturer, Department of Anaesthesia

Subhash Prasad Acharya, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu 44600

Intensivist

Gentle Sunder Shrestha, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu 44600

Department of Anesthesia

Diptesh Aryal, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu 44600

Anaesthesiologist and Intensivist

Moda Nath Marhatta, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu 44600

Head, Department of Anesthesia

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Published

2017-06-28

How to Cite

Shrestha, P. S., Acharya, S. P., Shrestha, G. S., Aryal, D., Udaya, R. K., & Marhatta, M. N. (2017). An audit of hepatobiliary diseases in a tertiary level intensive care unit in Nepal. Journal of Society of Anesthesiologists of Nepal, 4(1), 42–45. https://doi.org/10.3126/jsan.v4i1.17445

Issue

Section

Clinical Audit