Clinical, Biochemical and Endoscopic Evaluation of CLD Patients in a Tertiary Care Hospital of Bangladesh: A Cross-Sectional Study

Open Access

Abstract

Introduction: Chronic liver disease (CLD) is one of the common cause of sickness and death. This disease usually comes with a variety of different clinical, biochemical, and endoscopic signs, especially in case of developing countries like Bangladesh. A thorough assessment of all the variables is necessary for determining the extent of the disease and mode of treatment. Methods & Materials: This hospital-based cross-sectional observational study was conducted among indoor patients admitted to the Departments of Medicine and Hepatology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh, from April 2019 to March 2020. Data were analyzed using SPSS version 22.0. Results: Clinically, all patients presented with abdominal distension, with high frequencies of jaundice (82.0%) and abdominal pain (76.0%), indicating advanced disease; ascites (90.0%) and icterus (86.0%) were the most common examination findings. Hepatitis B virus was the leading etiology, 37 (74.0%). Biochemically, most patients had a serum–ascites albumin gradient (SAAG) of 1.50–1.99 g/dL (58.0%), suggesting portal hypertension. Endoscopic evaluation revealed that Grade II esophageal varices were most common (34.0%), followed by Grade III (28.0%) and Grade IV (20.0%). A progressive shift toward higher variceal grades was observed with increasing serum-ascites albumin gradient (SAAG), with the ≥2.0 g/dL group showing predominance of Grade IV varices, 9 (90.0%). Conclusion: Chronic liver disease (CLD) patients in this study predominantly presented at advanced stage, with middle-aged males and lower socioeconomic groups being mostly affected. Most had clinical and biochemical evidence of decompensation and portal hypertension, along with a high prevalence of moderate to severe esophageal varices.