Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
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Original Article

Volume 15, Number 1, February 2022, pages 26-32

Hemorrhagic Ascites Is Associated With Reduced Survival in Cirrhosis: A Systematic Review and Meta-Analysis

Figures

Figure 1.
Figure 1. Literature review process.
Figure 2.
Figure 2. Difference in acute kidney injury. CI: confidence interval.
Figure 3.
Figure 3. Difference in hepatic encephalopathy. CI: confidence interval.
Figure 4.
Figure 4. Difference in SBP. SBP: spontaneous bacterial peritonitis; CI: confidence interval.
Figure 5.
Figure 5. Difference in portal vein thrombosis. CI: confidence interval.
Figure 6.
Figure 6. Difference in ICU stay. ICU: intensive care; CI: confidence interval.
Figure 7.
Figure 7. Difference in 3-year mortality. CI: confidence interval.

Table

Table 1. Baseline Characteristics of the Included Studies
 
Study, yearDesitter et al, 1984 [13]Urrunaga et al, 2013 [10]Naqvi et al, 2020 [15]Yildiz et al, 2016 [14]
aComparative outcomes were reported in only 35 patients. NHA: non-hemorrhagic ascites; HA: hemorrhagic ascites; MELD; model for end-stage liver disease; N: total sample size; PT: prothrombin time; CTP: Child-Turcot-Pugh score; INR: international normalized ratio.
Sample size, n800a856838329
  HA39214223118
  NHA761642615211
Study designRetrospective, observational studyRetrospective, observational studyRetrospective, observational studyRetrospective, observational study
Baseline demographics
  HA
Mean age: 47 ± 11Median age: 51 (24 - 77)Median age: 44.8 ± 14.5Mean age: 58.3 ± 14.4
PT: 39 ± 20Gender: females 22%Gender: male 61%Gender: females 44%
Median MELD: 18 (6 - 46)Mean MELD: 23.1 ± 9Mean MELD: 21.5 ± 8.3
INR: 1.5 (0.9 - 5.8)INR: 1.8 ± 0.4INR: 1.7 ± 0.6
Platelets: 101 (11 - 660)Platelets: 121 ± 29Platelets: 108 ± 63.7
Mean CTP: 10 ± 1.7Mean CTP: 10.4 ± 2.1
  NHA
Mean age: 43 ± 12Median age: 51 (22 - 79)Mean age: 49 ± 13.4Mean age: 59.1 ± 12.8
PT: 35 ± 20Gender: females 22%Gender: male 62%Gender: females 75%
Median MELD: 16 (6 - 46)Mean MELD: 19.2 ± 6Mean MELD: 17.3 ± 6.6
INR: 1.4 (0.9 - 6.1)INR: 1.5 ± 0.3INR: 1.6 ± 0.4
Platelets: 112.5 (9 - 2,631)Platelets: 127 ± 49Platelets: 110 ± 91
Mean CTP: 9.1 ± 1Mean CTP: 9.8 ± 2.2
Etiology of cirrhosis
  HA
Alcoholic liver disease 95%Hepatitis C 52%, alcohol 33%, hepatitis B 4%, others 11%Hepatitis C 61%, hepatitis B 26%, Wilson disease 4%, hemochromatosis 1%Hepatitis B 38%, hepatitis C 11.2%, alcohol 7.8%, autoimmune 14.7%, others 28.4%
  NHA
Alcoholic liver disease 87%Hepatitis C 50%, alcohol 38%, hepatitis B 4%, others 8%Hepatitis C 61%, hepatitis B 26%, Wilson disease 4%, hemochromatosis 1%Hepatitis B 37.6%, hepatitis C 13.8%, alcohol 6.2%, autoimmune 15.7%, others 26.7%
Cause of HASpontaneous 33-51% (charts of seven patients could not be retrieved), hepatocellular carcinoma 28%, traumatic 18%, tuberculous peritonitis 2.6%Spontaneous 64.4%, hepatocellular carcinoma 17%, iatrogenic 13%, others 4.6 %, trauma 1%Spontaneous 79%, hepatocellular carcinoma 14%, iatrogenic 7.6%Spontaneous 82.3%, hepatocellular carcinoma 15.1%, iatrogenic 2.5%
Quality assessmentFairGoodGoodGood