{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T04:17:53Z","timestamp":1773375473007,"version":"3.50.1"},"reference-count":27,"publisher":"Instituto Nacional de Salud (Colombia)","issue":"Sp. 3","license":[{"start":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T00:00:00Z","timestamp":1703808000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T00:00:00Z","timestamp":1703808000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["revistabiomedica.org"],"crossmark-restriction":false},"short-container-title":["Biomed."],"abstract":"<jats:p>Introduction. Cirrhosis is one of the ten leading causes of death in the Western hemisphere and entails a significant cost of health care.Objective. To describe the sociodemographic, clinical, and laboratory characteristics of patients older than 18 years who received care for acute decompensation of cirrhosis in the emergency services of three highly complex centers in Medell\u00edn, Colombia.Materials and methods. This was an observational retrospective cohort study from clinical records. The results were analyzed by frequency measures and represented in tables and graphics.Results. In total, 576 clinical records met the inclusion criteria; 287 were included for analysis, and 58.9% were men, with an average age of 64 (\u00b1 13.5) years. The most frequent causes of cirrhosis were alcohol intake (47.7%), cryptogenic or unspecified etiology (29.6%), and non-alcoholic fatty liver disease (9.1%). The main reasons for visiting the emergency department were the presence of edema and\/or ascites (34.1%), suspicion of gastrointestinal bleeding (26.5%), abdominal pain (14.3%) and altered mental status (13.9%). The most frequent clinical manifestations of an acute decompensation of cirrhosis were ascites (45.6%), variceal hemorrhage (25.4%), hepatic encephalopathy (23.0%), and spontaneous bacterial peritonitis (5.2%). During their treatment, 56.1% of the patients received intravenous antibiotics; 24.0%, human albumin; 24.0%, vasoactive support, and 27.5%, blood products; 21.3% required management in an intensive or intermediate care unit, registering 53 deceased patients for a mortality of 18.5%.Conclusion. Patients who consult the emergency services due to acute decompensation of cirrhosis demand a high amount of health resources, frequently present associated complications, and a high percentage requires management in critical care units and shows a high in-hospital mortality rate.<\/jats:p>","DOI":"10.7705\/biomedica.6963","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T09:35:40Z","timestamp":1704792940000},"page":"9-20","update-policy":"https:\/\/doi.org\/10.7705\/crossmark","source":"Crossref","is-referenced-by-count":1,"title":["Characterization of patients with acutely decompensated cirrhosis who received care in different highly complex emergency services of Medell\u00edn, Colombia.","Caracterizaci\u00f3n de los pacientes con cirrosis agudamente descompensada que consultaron a diferentes servicios de urgencias de alta complejidad en Medell\u00edn, Colombia"],"prefix":"10.7705","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9065-3819","authenticated-orcid":false,"given":"Juan Luis","family":"V\u00e9lez","sequence":"first","affiliation":[{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"},{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7462-7488","authenticated-orcid":false,"given":"Andrea","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"},{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9953-0228","authenticated-orcid":false,"given":"Juan David","family":"Blanco","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"},{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9292-7484","authenticated-orcid":false,"given":"Marie Claire","family":"Berrouet","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia; Servicio de Toxicolog\u00eda Cl\u00ednica, Hospital General de Medell\u00edn \u201cLuz Castro de Guti\u00e9rrez,Medell\u00edn, Colombia"},{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia; Servicio de Toxicolog\u00eda Cl\u00ednica, Hospital General de Medell\u00edn \u201cLuz Castro de Guti\u00e9rrez,Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5767-6111","authenticated-orcid":false,"given":"Lorena","family":"Valencia","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"},{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7100-8956","authenticated-orcid":false,"given":"Sof\u00eda","family":"Soto","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"},{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8422-9491","authenticated-orcid":false,"given":"Ana Sof\u00eda","family":"Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"},{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1336-8114","authenticated-orcid":false,"given":"V\u00edctor","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia; Fundaci\u00f3n Universitaria San Mart\u00edn, Facultad de Medicina, Sabaneta, Colombia"},{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia; Fundaci\u00f3n Universitaria San Mart\u00edn, Facultad de Medicina, Sabaneta, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1023-1502","authenticated-orcid":false,"given":"Juan Luis","family":"Gallego","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"},{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7558-271X","authenticated-orcid":false,"given":"Julia","family":"Jaillier","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"},{"name":"Facultad de Medicina, Universidad CES, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4444","published-online":{"date-parts":[[2023,12,29]]},"reference":[{"key":"129095","unstructured":"Smith A, Baumgartner K, Bositis C. Cirrhosis: Diagnosis and management. Am Fam Physician. 2019;100:759-70."},{"key":"129096","doi-asserted-by":"crossref","unstructured":"Luj\u00e1n-Ramos MA, D\u00edaz-Ram\u00edrez GS, Mart\u00ednez-Casas OY, Morales-Ortiz AF, Donado-G\u00f3mez JH, Restrepo-Guti\u00e9rrez JC, et al. Caracterizaci\u00f3n de pacientes con cirrosis hep\u00e1tica y bacteriemia de un hospital universitario en Medell\u00edn, Colombia. Rev Colomb Gastroenterol. 2020;35:455-64. https:\/\/doi.org\/10.22516\/25007440.557","DOI":"10.22516\/25007440.557"},{"key":"129097","doi-asserted-by":"crossref","unstructured":"Tapper EB, Ufere NN, Huang DQ, Loomba R. Review article: Current and emerging therapies for the management of cirrhosis and its complications. Aliment Pharmacol Ther. 2022;55:1099-1115. https:\/\/doi.org\/10.1111\/apt.16831","DOI":"10.1111\/apt.16831"},{"key":"129098","doi-asserted-by":"crossref","unstructured":"Escorcia-Charris EJ, Marrugo-Balceiro WR. Caracterizaci\u00f3n epidemiol\u00f3gica y cl\u00ednica de la cirrosis hep\u00e1tica en un centro regional del caribe colombiano: Cl\u00ednica General del Norte enero 2012 a marzo 2017. Biociencias. 2018;13:17-30. https:\/\/doi.org\/10.18041\/2390-0512\/bioc.1.2242","DOI":"10.18041\/2390-0512\/bioc..1.2242"},{"key":"129099","doi-asserted-by":"crossref","unstructured":"Bosetti C, Levi F, Lucchini F, Zatonski WA, Negri E, La Vecchia C. Worldwide mortality from cirrhosis: An update to 2002. J Hepatol. 2007;46:827-839. https:\/\/doi.org\/10.1016\/j.jhep.2007.01.025","DOI":"10.1016\/j.jhep.2007.01.025"},{"key":"129100","doi-asserted-by":"crossref","unstructured":"Hitoshi Y, Sumiko N, Takemi A, Yoshinari A, Yoshiyuki U, Koji O, et al. Evidence-based clinical practice guidelines for Liver Cirrhosis 2020. J Gastroenterol. 2021;56:593-619. https:\/\/doi.org\/10.1007\/s00535-021-01788-x","DOI":"10.1007\/s00535-021-01788-x"},{"key":"129101","doi-asserted-by":"crossref","unstructured":"Ge PS, Runyon BA. Treatment of patients with cirrhosis. N Engl J Med. 2016;375:767-77. https:\/\/doi.org\/10.1056\/nejmra1504367","DOI":"10.1056\/NEJMra1504367"},{"key":"129102","doi-asserted-by":"crossref","unstructured":"Long B, Koyfman A. The emergency medicine evaluation and management of the patient with cirrhosis. Am J Emerg Med. 2018;36:689-98. https:\/\/doi.org\/10.1016\/j.ajem.2017.12.047","DOI":"10.1016\/j.ajem.2017.12.047"},{"key":"129103","doi-asserted-by":"crossref","unstructured":"Holgu\u00edn A, Hurtado JJ, Restrepo JC. Una mirada actual a la peritonitis bacteriana espont\u00e1nea. Rev Colomb Gastroenterol. 2016;30:315-24. https:\/\/doi.org\/10.22516\/25007440.56","DOI":"10.22516\/25007440.56"},{"key":"129104","unstructured":"Quiroz ME, Flores Y, Aracena B, Granados-Garc\u00eda V, Salmer\u00f3n J, P\u00e9rez R, et al. Estimating the cost of treating patients with liver cirrhosis at the Mexican Social Security Institute. Salud Publica Mex. 2010;52:493-501. https:\/\/doi.org\/10.1590\/S0036-36342010000600003"},{"key":"129105","doi-asserted-by":"crossref","unstructured":"Prieto JE, S\u00e1nchez S, Prieto RG, Rojas EL, Gonz\u00e1lez L, Mendivelso F. Caracter\u00edsticas cl\u00ednicas y descompensaci\u00f3n en pacientes con cirrosis hep\u00e1tica atendidos en dos centros de hepatolog\u00eda en la ciudad de Bogot\u00e1 D.C., 2010-2014. Rev Colomb Gastroenterol. 2016;31:1-8. https:\/\/doi.org\/10.22516\/25007440.66","DOI":"10.22516\/25007440.66"},{"key":"129106","unstructured":"Giraldo AM, Barraza AM, Villa VH, Mart\u00ednez JW, Garc\u00eda-Castro G. Caracterizaci\u00f3n epidemiol\u00f3gica de pacientes con cirrosis en una consulta de gastroenterologia en Pereira, Colombia, 2009-2012. Rev M\u00e9dica Risaralda. 2014;20:86-94."},{"key":"129107","doi-asserted-by":"crossref","unstructured":"MacIntosh T. Emergency management of spontaneous bacterial peritonitis - A clinical review. Cureus. 2018;10:1-11. https:\/\/doi.org\/10.7759\/cureus.2253","DOI":"10.7759\/cureus.2253"},{"key":"129108","doi-asserted-by":"crossref","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Lancet. 2007;370:1453-7. https:\/\/doi.org\/10.1016\/S0140-6736(07)61602-X","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"129109","unstructured":"Medell\u00edn C\u00f3mo Vamos. \u00c1rea Metropolitana. Alcald\u00eda de Medell\u00edn. Accessed: March 16, 2023. Available at: https:\/\/www.medellincomovamos.org\/territorio\/area-metropolitana-delvalle-de-aburra"},{"key":"129110","unstructured":"Alcald\u00eda de Medell\u00edn. Datos generales de Medell\u00edn que debes conocer. 2021. Accessed: March 16, 2023. Available at: https:\/\/www.medellin.gov.co\/es\/conoce-algunos-datosgenerales-de-la-ciudad\/"},{"key":"129111","unstructured":"Departamento Administrativo Nacional de Estad\u00edstica DANE. \u00bfCu\u00e1ntos somos? Accessed: March 16, 2023. Available at: https:\/\/www.dane.gov.co\/index.php\/estadisticas-por-tema\/demografia-y-poblacion\/censo-nacional-de-poblacion-y-vivenda-2018\/cuantos-somos"},{"key":"129112","doi-asserted-by":"crossref","unstructured":"Cort\u00e9s-Mancera F, Loureiro CL, Hoyos S, Restrepo JC, Correa G, Jaramillo S, et al. Etiology and viral genotype in patients with end-stage liver diseases admitted to a hepatology unit in Colombia. Hepat Res Treat. 2011;2011:1-10. https:\/\/doi.org\/10.1155\/2011\/363205","DOI":"10.1155\/2011\/363205"},{"key":"129113","unstructured":"Ministerio de Justicia y del Derecho - Observatorio de Drogas de Colombia, Departamento Administrativo Nacional de Estad\u00edstica, DANE. Bolet\u00edn T\u00e9cnico Encuesta Nacional de Consumo de Sustancias Psicoactivas Colombia. 2020;3:1-34. Accessed: March 16, 2023. Available at: https:\/\/www.dane.gov.co\/files\/investigaciones\/boletines\/encspa\/btencspa-2019.pdf"},{"key":"129114","doi-asserted-by":"crossref","unstructured":"Zubieta RR, G\u00f3mez CJ, Rodr\u00edguez AR, Ariza KA, Toloza NA. Hospital mortality in cirrhotic patients at a tertiary care center. Rev Gastroenterol Mex. 2017;82:203-9. https:\/\/doi.org\/10.1016\/j.rgmx.2016.10.002","DOI":"10.1016\/j.rgmxen.2016.10.005"},{"key":"129115","doi-asserted-by":"crossref","unstructured":"Nadim MK, Garc\u00eda-Tsao G. Acute kidney injury in patients with cirrhosis. N Engl J Med. 2023;388:733-45. https:\/\/doi.org\/10.1056\/NEJMra2215289","DOI":"10.1056\/NEJMra2215289"},{"key":"129116","doi-asserted-by":"crossref","unstructured":"Francoz C, Durand F, Kahn JA, Genyk YS, Nadim MK. Hepatorenal syndrome. Clin J Am Soc Nephrol. 2019;14:774-81. https:\/\/doi.org\/10.2215\/CJN.12451018","DOI":"10.2215\/CJN.12451018"},{"key":"129117","doi-asserted-by":"crossref","unstructured":"Ospina JR, Restrepo JC. S\u00edndrome hepatorrenal: fisiopatolog\u00eda, diagn\u00f3stico y manejo. Rev Colomb Gastroenterol. 2017;31:146-53. https:\/\/doi.org\/doi:10.22516\/25007440.83","DOI":"10.22516\/25007440.83"},{"key":"129118","doi-asserted-by":"crossref","unstructured":"Santos O, Londo\u00f1o M, Mar\u00edn J, Mu\u00f1oz O, Mena \u00c1, Guzm\u00e1n C, et al. An experience of liver transplantation in Latin America: A medical center in Colombia. Colomb Med (Cali). 2015;46:8-13.","DOI":"10.25100\/cm.v46i1.1400"},{"key":"129119","doi-asserted-by":"crossref","unstructured":"Liou IW. Management of end-stage liver disease. Med Clin North Am. 2014;98:119-152. https:\/\/doi.org\/10.1016\/j.mcna.2013.09.006","DOI":"10.1016\/j.mcna.2013.09.006"},{"key":"129120","doi-asserted-by":"crossref","unstructured":"H\u00e4ussinger D, Dhiman RK, Felipo V, G\u00f6rg B, Rajiv J, Kircheis G, et al. Hepatic encephalopathy. Nat Rev Dis Prim. 2022;8. https:\/\/doi.org\/doi:10.1038\/s41572-022-00366-6","DOI":"10.1038\/s41572-022-00366-6"},{"key":"129121","doi-asserted-by":"crossref","unstructured":"Chuang C-J, Wu Y-F, Wu K-H, Chen Y-C. Patients with liver cirrhosis as frequent attenders of emergency departments. Emerg Med Int. 2020;2020:1-6. https:\/\/doi.org\/doi:10.1155\/2020\/8289275","DOI":"10.1155\/2020\/8289275"}],"container-title":["Biom\u00e9dica"],"original-title":[],"link":[{"URL":"https:\/\/revistabiomedica.org\/index.php\/biomedica\/article\/download\/6963\/5291","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/revistabiomedica.org\/index.php\/biomedica\/article\/download\/6963\/5479","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/revistabiomedica.org\/index.php\/biomedica\/article\/download\/6963\/5291","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T15:15:18Z","timestamp":1773328518000},"score":1,"resource":{"primary":{"URL":"https:\/\/revistabiomedica.org\/index.php\/biomedica\/article\/view\/6963"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,29]]},"references-count":27,"journal-issue":{"issue":"Sp. 3","published-online":{"date-parts":[[2023,12,29]]}},"URL":"https:\/\/doi.org\/10.7705\/biomedica.6963","relation":{},"ISSN":["2590-7379","0120-4157"],"issn-type":[{"value":"2590-7379","type":"electronic"},{"value":"0120-4157","type":"print"}],"subject":[],"published":{"date-parts":[[2023,12,29]]},"assertion":[{"value":"2023-12-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}},{"value":"Yes","order":0,"name":"peer_reviewed","label":"Peer Reviewed","group":{"name":"peer_review","label":"Peer Review"}},{"value":"Instituto Nacional de Salud","name":"publisher","label":"This article is maintained by"},{"value":"Biomedica","name":"journaltitle","label":"Journal Title"},{"value":"Art\u00edculos originales","name":"content_type","label":"Content Type"}]}}