early paracentesis

Q: 44 years old homeless man with no previous medical record is brought to ICU with encephalopathy. On examination patient is found to have moderate ascites, probably due to alcoholic cirrhosis. Early paracentesis on admission is found to decrease mortality rate.

A) True

B) False

Answer: A

Although sometimes diagnosis may be apparent like patient in this question, the objective of the question is to emphasize that performing early paracentesis in patients with ascites may decrease mortality rates. This evidence comes from a study of about 18,000 patients with cirrhosis and ascites who were admitted to the hospital with a principle diagnosis of ascites or encephalopathy. The patients who received paracentesis had lower in-hospital mortality rates (adjusted odds ratio 0.55).

This is due the fact that, this not only confirms the apparent cause of ascites but may identify unexpected diagnoses.

#procedures

Reference:

Orman ES, Hayashi PH, Bataller R, Barritt AS 4th. Paracentesis is associated with reduced mortality in patients hospitalized with cirrhosis and ascites. Clin Gastroenterol Hepatol 2014; 12:496.