P- 89 CHARACTERISTICS AND SURVIVAL OF PATIENTS WITH LIVER CIRRHOSIS AT A REFERRAL CENTER IN PARAGUAY

Abstract

Introduction and Objectives: There is little information on the survival and characteristics of cirrhotic patients in Paraguay. This information is vital to generate public policies that allow access to effective treatments. This study aimed to determine the survival of outpatients with liver cirrhosis in a gastroenterology and hepatology department in Paraguay. Materials and Methods: Observational and retrospective design. Medical records of outpatients with cirrhosis whose first consultation was in 2019 were reviewed. Survival estimation was performed with the Kaplan-Meier model. Results: 96 patients included. Average age: 54±15 years. Cirrhosis etiology: alcohol: 35%; autoimmune:18%; unknown:15%; cholestatic:13%; NAFLD:11%; viral:6%; hemochromatosis:2%. 72% of patients presented decompensation in the first consultation: ascites: 58%; acute variceal bleeding (AVB): 32%; hepatic encephalopathy (HE): 15%. Overall survival at 12 and 24 months was 81% and 67.5%, respectively. Comparing CP-A with CP-B+C, survival at one year and two years was 72% and 58%, respectively (p=0.034). Survival among patients with MELD <15 and ≥15 was: 89.2% vs. 69.8% per year and 80% vs. 51.5% at two years (p=0.01). The survival of patients with ascites was 70% and 53% at 1 and 2 years, respectively, compared to the group without ascites, 94% and 86% (p=0.002 and 0.001). There is no significant difference between patients with AVB vs. non-AVB (survival of 78.3% and 74.1% at 1 and 2 years). The group with HE had lower survival at two years (24.6%, p=0.04). Conclusions: Cirrhotic patients in Paraguay have survival rates similar to those reported in the literature. Unlike many countries in the region, cirrhosis secondary to viral hepatitis is not very prevalent in this group. More studies are needed to determine if this situation can be extrapolated to the country in general.