Title Monocentrično istraživanje značajki, komorbiditeta i povezanosti komplikacija sa smrtnim ishodom kod pacijenata s cirozom jetre
Title (english) A monocentric study on characteristics, comorbidities and complications that lead to fatal outcome in patients with liver cirrhosis
Author Mirjana Novoselac Zalogaj
Mentor Tomislav Meštrović (mentor)
Committee member Ivan Milas (predsjednik povjerenstva)
Committee member Tomislav Meštrović (član povjerenstva)
Committee member Ivo Dumić-Čule (član povjerenstva)
Granter University North (University centre Varaždin) (Department of Nursing) Koprivnica
Defense date and country 2022-09-28, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Public Health and Health Care Public Health
Abstract U ljudskom organizmu jetra je jedan od najvažnijih organa. Ciroza jetre je difuzna bolest koja je karakterizirana fibrozom i konverzijom normalne jetrene građe u strukturno abnormalne nodule koji su izgubili normalnu lobularnu organizaciju. Normalnu strukturu jetre u potpunosti narušava fibrozno tkivo što dovodi do skvrčavanja jetre. Ciroza jetre nastaje kao posljedica različitih oblika bolesti koje izazivaju oštećenja u jetri i jetrenim stanicama. Ciroza jetre, zadnji je stadij kronične bolesti jetre koja ima za posljedicu niz patofizioloških poremećaja i kliničkih manifestacija, koje se kod pojedinih pacijenata mogu javiti u različitim kombinacijama ili samostalno. Komplikacije koje se razvijaju kod uznapredovale ciroze jetre su portalna encefalopatija, portalna hipertenzija, krvarenja iz varikoziteta, splenomegalija, ascites, karcinom jetre i jetrena koma. Rang lista HZJZ-a iz 2020. godine stavlja cirozu jetre na 10. mjesto uzroka smrti kod muškaraca u Republici Hrvatskoj. Cilj ovog diplomskog rada je detaljno opisati opće karakteristike pacijenata hospitaliziranih u OB Virovitica na internom odjelu zbog ciroze jetre u vremenskom periodu od 01.01.2019. do 31.12.2021., uključujući dob i spol, te kliničke karakteristike tih pacijenata, i to s obzirom na otpusnu dijagnozu, broj rehospitalizacija, infekcije mokraćnog sustava i podjelu komorbititeta s obzirom na spol, te povezanost smrtnosti s portalnom hipertenzijom, toksičnom encefalopatijom i alkoholnim hepatitisom. Podatci pacijenata obuhvaćenih ovim istraživanjem prikupljeni su za svakog pojedinačnog bolesnika iz bolničke medicinske dokumentacije u Općoj bolnici Virovitica na internom odjelu te su potom prikupljeni u za to pripremljenu i namijenjenu tablicu u programu Microsoft Excel 2019. Na prikupljenim podatcima učinjena je statistička analiza i obrada podataka te su prikazane povezanosti između unaprijed definiranih varijabli. Rezultati istraživanja iskazani su prikazom učestalosti pojedinih vrijednosti pridruženih prikupljenim varijablama i izračunavanjem omjera šansi (OR) uz 95%-tne intervale pouzdanosti (CI) i p-vrijednosti za testirane hipoteze. U zaključku ovog diplomskog rada osvrnula bih se na mogućnost poboljšanja kvalitete života bolesnika oboljelih od ciroze jetre, a sve u svrhu postizanja njihovog osobnog zadovoljstva, te kvalitetne uže i šire socijalne zajednice. U samom procesu izlječenja potpora obitelji oboljelog je najznačajnija za bolesnika za vrijeme hospitalizacije u zdravstvenoj ustanovi i nakon otpuštanja bolesnika iz bolnice. Vrlo je važno obaviti edukaciju bolesnika i njegove obitelji o samoj bolesti i njezinim komplikacijama, te uključivanje multidisciplinarnih timova u proces liječenja bolesnika i uključivanje bolesnika i obitelji u klub liječenih alkoholičara (KLA).
Abstract (english) In the human body, the liver is one of the most important organs. Liver cirrhosis is a diffuse disease characterized by fibrosis and conversion of normal liver structure into structurally abnormal nodules that have lost their normal lobular organization. The normal structure of the liver is completely destroyed by fibrous tissue, which leads to liver shrinkage. Cirrhosis of the liver occurs as a result of various forms of disease that cause damage to the liver and liver cells. Cirrhosis of the liver is the last stage of chronic liver disease, which results in a series of pathophysiological disorders and clinical manifestations, which in individual patients can appear in different combinations or independently. Complications that develop in advanced liver cirrhosis are portal encephalopathy, portal hypertension, variceal bleeding, splenomegaly, ascites, liver cancer and hepatic coma. The ranking of the HZJZ from 2020 places cirrhosis of the liver in the 10th place as a cause of death in men in the Republic of Croatia. The aim of this thesis is to describe in detail the general characteristics of patients hospitalized in the OB Virovitica in the internal department due to cirrhosis of the liver in the period from 01.01.2019. until 31.12.2021, including age and sex, and the clinical characteristics of these patients, with regard to the discharge diagnosis, the number of rehospitalizations, urinary tract infections and the distribution of comorbidities with regard to gender, and the association of mortality with portal hypertension, toxic encephalopathy and alcoholic hepatitis. The data of the patients included in this research were collected for each individual patient from the hospital medical records at the Virovitica General Hospital in the internal department and were then collected in a table prepared and intended for this purpose in the Microsoft Excel 2019 program. Statistical analysis and data processing were performed on the collected data and connections between predefined variables are shown. The results of the research are presented by showing the frequency of individual values associated with the collected variables and by calculating the odds ratio (OR) with 95% confidence intervals (CI) and p-values for the tested hypotheses. In the conclusion of this thesis, I would like to look at the possibility of improving the quality of life of patients suffering from cirrhosis of the liver, all with the aim of achieving their personal satisfaction, as well as the quality of the immediate and wider social community. In the very process of healing, the support of the patient's family is the most important for the patient during hospitalization in a health facility and after the patient's discharge from the hospital. It is very important to educate the patient and his family about the disease itself and its complications, as well as involving multidisciplinary teams in the process of treating the patient and involving the patient and family in the club of treated alcoholics (KLA).
Keywords
ciroza jetre
portalna hipertenzija
ascites
krvarenja
portalna encefalopatija
jetrena koma
primarni karcinom jetre
Keywords (english)
liver cirrhosis
portal hypertension
ascites
bleeding
portal encephalopathy
hepatic coma
primary liver cancer
Language croatian
URN:NBN urn:nbn:hr:122:370088
Study programme Title: Nursing Study programme type: university Study level: graduate Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2022-10-26 13:17:30