RISK FACTORS ASSOCIATED WITH MORTALITY IN PATIENTS WITH REFRACTORY ASCITES IN A REFERRAL HOSPITAL IN LIMA, PERU"

Introduction and Objectives

Refractory ascites is defined as ascites unresponsive to sodium-restricted diet and maximum tolerated doses of diuretics. It is associated with poor prognosis and high mortality. Once diagnosed, the outlook worsens, with survival rates of approximately 50% at six months and 25% at one year, along with significantly impaired quality of life.

To identify risk factors associated with mortality in patients with refractory ascites.

Materials and Methods

This retrospective, observational study aimed to identify risk factors associated with mortality in patients with refractory ascites. A total of 102 patients from an electronic database were analyzed between 2020 and 2023. Those with incomplete data or non-cirrhotic ascites were excluded. Logistic regression analysis was used to identify risk factors, considering a p-value <0.005 as significant

Results

The average age was 66.6 years; 60.7% were male. The most common etiology was MASLD (42%). According to Child-Pugh classification, 1% were class A, 73% class B, and 25% class C. At the time of analysis, 73% of patients had died. Hepatorenal syndrome (HRS) occurred in 20.3%, and acute kidney injury (AKI) in 58%. Mean arterial pressure averaged 67.6 mmHg.

Multivariate analysis identified HRS, AKI, advanced age, and Child-Pugh class C as independent risk factors for mortality.

Conclusions

patients with refractory ascites have a high mortality rate. The presence of HRS, AKI, older age, and worse liver function (Child-Pugh C) are significant predictors of death in this population.

Conflict of interest: None

Variable	OR	2.5%	p-value
Age	1.18	1.07 – 1.32	<0.001
AKI	4.74	1.46 – 19.38	0.008
SHR	4.17	0.82- 48.18	0.021
MAP at Admission	1.02	0.99-1.04	0.503
Child-Pugh (C)	5.44	1.43-33.12	0.015
sodium	0.93	0.77-1.10	0.810