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.
|Titolo:||Role of Comorbidities in the General Management of Compensated Cirrhosis, Including Malnutrition|
|Settore Scientifico Disciplinare:||Settore MED/09 - Medicina Interna|
Settore MED/12 - Gastroenterologia
|Data di pubblicazione:||2016|
|Digital Object Identifier (DOI):||10.1007/978-3-319-23018-4_22|
|Tipologia:||Book Part (author)|
|Appare nelle tipologie:||03 - Contributo in volume|