Causes Of Ascites And Its Correlation With Serum-Ascites Albumin Gradient In Patients Admitted At Medical Wards In A Tertiary Hospital In Ghana.

Abstract

Objective: Ascites can be classified depending on whether it results from portal hypertension (PH) or non-portal hypertension (NPH) causes. This classification is relevant because the modes of evaluation and management are different for these two groups. Serum-ascites albumin gradient (SAAG) has been proposed in many studies to categorise ascites better than ascetic fluid total protein. This has not been determined in Ghanaian patients with ascites. The aim of this study was to determine the aetiology of ascites and to assess the performance of SAAG in the classification of portal versus non-portal hypertension ascites among patients admitted to a tertiary hospital in Ghana.

Methodology: A cross-sectional study was conducted at the Korle-Bu Teaching hospital, where 140 patients with ascites were recruited within the study period. Data on socio-demography, clinical features, and results of relevant laboratory investigations and imaging studies were collected using pretested questionnaires

Results: The mean age of patients was 44.7±13.2 years. Chronic liver disease (CLD) was the major cause of ascites in this study representing 73.57%. SAAG had a sensitivity of 91.59%, positive predictive value of 95.15% and diagnostic accuracy of 90.0% in classifying ascites as due to a PH or NPH.

Conclusion: CLD was the major cause of ascites in Ghanaian patients. SAAG has satisfactory diagnostic accuracy in differentiating ascites related to PH from NPH causes. This could be used as a first line investigation in the aetiological diagnosis of ascites for initiation of prompt treatment.