At the time of diagnosis, up to 40% of patients with cirrhosis suffer from at least one other disease. This observation underscores an important problem in daily practice because comorbidities can influence the management of portal hypertension and can play a role in the evolution of cirrhosis by constituting an additional risk of decompensation and mortality. In compensated cirrhosis the best studied comorbidity is obesity that is an independent risk factor of first decompensation. Comorbidities in need of surgery, the most frequent gallstones and hernia, are also a frequent clinical problem to face since the intervention may increase the risk of decompensation and mortality. At present the Mayo Clinic score is the most validated to predict perioperative and postoperative mortality. Malnutrition is a frequent feature in patients with cirrhosis. In the same fashion of non-cirrhotic patients, malnutrition influences the quality of life of patients with cirrhosis. Moreover, it can have an impact on mortality and the development of ascites, HE, or variceal bleeding in patients with compensated cirrhosis, but further studies are needed to draw definitive conclusions on this topic.
Role of Comorbidities in the General Management of Compensated Cirrhosis, Including Malnutrition / M. Rudler, V. La Mura - In: Portal Hypertension VI / [a cura di] R. de Franchis. - [s.l] : Springer, 2016. - ISBN 9783319230177. - pp. 205-214 [10.1007/978-3-319-23018-4_22]
Role of Comorbidities in the General Management of Compensated Cirrhosis, Including Malnutrition
V. La Mura
2016
Abstract
At the time of diagnosis, up to 40% of patients with cirrhosis suffer from at least one other disease. This observation underscores an important problem in daily practice because comorbidities can influence the management of portal hypertension and can play a role in the evolution of cirrhosis by constituting an additional risk of decompensation and mortality. In compensated cirrhosis the best studied comorbidity is obesity that is an independent risk factor of first decompensation. Comorbidities in need of surgery, the most frequent gallstones and hernia, are also a frequent clinical problem to face since the intervention may increase the risk of decompensation and mortality. At present the Mayo Clinic score is the most validated to predict perioperative and postoperative mortality. Malnutrition is a frequent feature in patients with cirrhosis. In the same fashion of non-cirrhotic patients, malnutrition influences the quality of life of patients with cirrhosis. Moreover, it can have an impact on mortality and the development of ascites, HE, or variceal bleeding in patients with compensated cirrhosis, but further studies are needed to draw definitive conclusions on this topic.File | Dimensione | Formato | |
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