Analysis of Causes of Death in Patients with Alcoholic Liver Cirrhosis Associated with Non-alcoholic Fatty Liver Disease
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Abstract
Today, it has been proven that about 10% of deaths among young and middle-aged people relate to the consumption of alcoholic beverages. Alcohol is ranked third among the causes of mortality in young people after tobacco and arterial hypertension, and second place – among the causes of liver transplantation inEurope. InUkraine, mortality due to alcoholic liver disease (ALD) has taken second place in the structure of causes of death from diseases of the digestive system.
The objective: to study the peculiarities of the causes of death in patients with ALD at the stage of liver cirrhosis (LC) associated with nonalcoholic fatty liver disease (NAFLD) on the basis of the analysis of pathoanatomical research protocols.
Materials and methods. 216 protocols of the pathoanatomical study of the patients who died from LC have been analyzed.
Results. It was found that people who abused alcohol died at the stage of subcompensation and compensation from pancreatic necrosis, and at the stage of decompensation – from the gastrointestinal bleeding (GIB) (more than half patients), hepatic, hepatic-renal insufficiency (HRI) and sepsis. The causes of death of people with NAFLD at the stages of compensation and subcompensation were myocardial infarction, cardiogenic shock, pulmonary embolism, mesenteric thrombosis and brain stroke; and in the stage of decompensation in most cases the hepatic and HRI were detected. In patients with a combination of ALD disease and NAFLD at the stage of LC, the causes of death were the following disorders at the stage of compensating: myocardial infarction, cardiogenic shock, pulmonary embolism, mesenteric thrombosis, brain stroke and pancreatic necrosis; at the stage of subcompensation, apart from the mentioned disorders, were: GIB and sepsis, and at the stage of decompensation there were myocardial infarction, cardiogenic shock, pulmonary embolism, mesenteric thrombosis, brain stroke, hepatic and HRI, GIB, sepsis, and hepatocellular carcinoma (5.7% of patients).
Conclusions. Patients with NAFLD at the stages of compensation and subcompensation of LC are more likely to have acute cardiovascular mortality than patients with ALD. Patients with a combination of ALD and NAFLD, in addition to acute cardiovascular mortality, have more often septicemia and HRI, and hepatocellular carcinoma is diagnosed.##plugins.themes.bootstrap3.article.details##
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