Observational Prospective Study.at the End of the Study the Patients Will be Classified According to PH,Serum Bicarbonate and Serum Sodium Into 6 Groups and Statistical Analysis Will be Performed Using Spss

Study Overview
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Brief Summary
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1-to identify the prognostic value of serum bicarbonate and serum electrolytes at time of admission and their association with development of complications ,length of hospital stay ,prognosis and mortality in hospitalized cirrhotic patient

Detailed Description
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the purpose of this study will be explore the impact of data obtained for the arterial blood gas parameters and serum bicarbonate and electrolytes at the time of hospital admission on adverse clinical outcomes ,duration of length of hospital stay and mortality in patients with cirrhosis .Furthermore incorporation these parameters into model of end stage liver disease could help to improve the prognostic value of MELDscore in comparison to the prognostic value of traditional equation of original MELD and child score

Official Title
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Impact of Serum Bicarbonate and Electrolytes on Adverse Outcomes in Decompensated Cirrhotic Patients in Sohag University Hospital

Conditions
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Liver Cirrhosis

Intervention / Treatment
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* Diagnostic Test: arterial blood gases and serum electrolytes


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with confirmed diagnosis of cirrhosis (age >18 years ) who will be admitted to internal medicine department or will be admitted to intermediate care unit willing and agree to be included in the study Exclusion Criteria: patients without evidence of cirrhosis cirrhotic patients whom -younger than 18 years old have diabetic ketoacidosis with acute coronary syndrome with fulminant liver failure with heart failure with organ transplantation when arterial blood gases not be available patient refusal patient with HCC

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| MELD score group A<br>MELD score :group A<25 | Diagnostic Test: arterial blood gases and serum electrolytes<br>* arterial bloog gases parameters serum potassium serum sodium serum calcium<br>|
| MELD group B<br>Group B>25 | Diagnostic Test: arterial blood gases and serum electrolytes<br>* arterial bloog gases parameters serum potassium serum sodium serum calcium<br>|
| MELD-PACO2 Group C<br>Group C<25 | Diagnostic Test: arterial blood gases and serum electrolytes<br>* arterial bloog gases parameters serum potassium serum sodium serum calcium<br>|
| MELD -PACO2 Group D<br>Group D>25 | Diagnostic Test: arterial blood gases and serum electrolytes<br>* arterial bloog gases parameters serum potassium serum sodium serum calcium<br>|
| MELD-BICARBONATE score Group E<br>Group E<23 | Diagnostic Test: arterial blood gases and serum electrolytes<br>* arterial bloog gases parameters serum potassium serum sodium serum calcium<br>|
| MELD-BICARBONATE Group F<br>Group F>23 | Diagnostic Test: arterial blood gases and serum electrolytes<br>* arterial bloog gases parameters serum potassium serum sodium serum calcium<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| will be ICU admitted | will be admitted to ICU due to progression of the disease complications as shok,hepatorenal syndrome,severe infection,starting renal replacement therapy and icu intervention as mechanical ventilation using MELD score and child score depending on ABGparameters and serum electrolytes . | from the day of admission to the day of discharge from hospital or death during hospitalization |