A Study of Clinical Profile of Hypertension in Elderly Age Group in Tertiary Care Hospital

Abstract

 Introduction: Decompensated alcoholic liver disease (DALD) is a major cause of morbidity and mortality worldwide, with complications including ascites, hepatic encephalopathy, hepatorenal syndrome, and spontaneous bacterial peritonitis. Hyponatremia, defined as serum sodium <135 mEq/L, is common in cirrhosis and strongly influences prognosis. This study was conducted to evaluate the clinical significance of serum sodium levels and their correlation with disease severity in patients with DALD.

Material & Methods: A prospective observational study was conducted at a tertiary care center from July 2023 to June 2025. A total of 180 male patients aged >18 years, diagnosed with DALD, were enrolled based on clinical, biochemical, and imaging findings. Patients with cardiac failure, chronic kidney disease, or on interfering medications were excluded. Clinical history, laboratory investigations, and imaging were recorded. Disease severity was assessed using Model for End-Stage Liver Disease (MELD), MELD-Na, and Child-Pugh scoring systems. Data were analyzed using SPSS, with p <0.05 considered significant.

Results: Among 180 patients, the majority were aged 36–50 years (62.78%), with farming as the most common occupation (27.78%). Hyponatremia (<135 mEq/L) was present in 34.44%, normonatremia in 51.11%, and hypernatremia in 14.44%. Patients with sodium <135 mEq/L demonstrated higher MELD scores (27–31 in 13.89% cases) and were more frequently classified as Child-Pugh class C (22.78%). Hyponatremia was strongly associated with severe complications, including ascites, hepatic encephalopathy, and hepatorenal syndrome.

Conclusion: Serum sodium is a simple, inexpensive, and reliable biomarker in DALD. Hyponatremia correlates with advanced disease severity and poor prognosis, emphasizing its utility in risk stratification. Integration of serum sodium into prognostic scoring systems like MELD-Na enhances predictive accuracy, supporting early intervention and improved patient management in tertiary care settings.