| Popis: |
Background: Complications of liver cirrhosis constitute major economic burden for developing nations like Pakistan. Objective: This study aimed to uncover economic & social issues faced by cirrhotic patients. Methods: The study was carried out at the Department of Gastroenterology & Hepatology, Shaikh Zayed Hospital, Lahore, Pakistan. Patients with liver cirrhosis were recruited and information regarding disease, financial status, treatment expenses & dependency was recorded. Results: 450 patients were recruited, 272(60%) males & 178(40%) females, with average age 55 years. HCV was present in 388 (86%). 293 (65%) were diagnosed incidentally and 119(26.5%) discovered cirrhosis within past year. 197 (43.8%) never received antiviral therapy. 242 (54%) had co-morbid conditions including DM, HTN & IHD. 170 (38%) had HCC. Only 10 (2%) had received HBV vaccine. 415 (92%) depended on family members for basic activities. 272 (60%) were visiting up to twice monthly in outpatient clinic. 442 (98%), had been admitted to hospital up to 10 times with complications of cirrhosis, spending $300-700 per admission. 105 (23%) had monthly income of $100-200. 118 (26%) were sole earning family members while 359 (80%) were financially dependent on family. 113 (25%) liquidated personal property/belongings while 345 (76.7%) borrowed money to fund treatment. 218 (48%) were liver transplant candidates, with 10(2%) affording it. 2 (0.4%) patients had employer-supported treatment and none had health insurance. Conclusion: Our study shows the financial difficulties & dependency faced by patients with liver cirrhosis. Aggressive national screening is required to discover infected patients before cirrhosis develops. Incidentally it also underlines the inadequate 2% adult HBV vaccination rate. Funding Statement: None to declare. Declaration of Interests: None to declare. Ethics Approval Statement: Ethical approval from institutional review board and informed consent from those recruited. |
