Significance of Laboratory Findings and Esophageal Varices in Male Patients With Decompensated Alcoholic Liver Cirrhosis: A Single-Center Experience.

Introduction Alcoholic liver disease represents a growing global pandemic, particularly among younger men, and is one of the leading causes of premature death worldwide. Observing complications during the decompensation stage and monitoring disease progression dynamics using scoring systems are particularly important. Materials and methods This retrospective-prospective, descriptive, and analytical study included 123 male patients with a confirmed diagnosis of alcoholic liver cirrhosis, hospitalized at the Internal Medicine Clinic, University Clinical Centre of the Republic of Srpska in Banja Luka, Department of Gastroenterology and Hepatology. The study period spanned from January 2023 to January 2025, with the note that patient selection and monitoring began much earlier, in June 2021. After hospitalization, patients were followed monthly through a program of outpatient control examinations, with disease outcomes recorded. The study included all male patients over 18 years of age with a confirmed diagnosis of alcoholic liver cirrhosis and signed informed consent. Female patients and those with cirrhosis or other etiologies were excluded. For statistical data analysis, the Statistical Package for the Social Sciences (SPSS) version 29 (IBM Corp., Armonk, NY, USA) was used. The statistical analyses performed included median, standard deviation, analysis of variance, Student's t-test, chi-square test, and survival analysis. Results The mean age of the patients was 59.09±9.316 years. Most of them had anemia: 113 patients (91.86%) with decreased erythrocytes and 109 patients (88.62%) with decreased hemoglobin. Thrombocytopenia was observed in 104 patients (84.55%), while an increased mean corpuscular volume (MCV) was recorded in 68 patients (55.28%). Among biochemical parameters, the most common findings were increased bilirubin in 98 patients (79.67%), aspartate aminotransferase (AST) in 111 patients (90.24%), gamma-glutamyl transferase (GGT) in 109 patients (88.61%), and D-dimer in 110 patients (89.44%), while albumin levels were decreased in 107 patients (87.00%). Hyponatremia (decreased sodium) was observed in 63 patients (51.21%), and hypercalcemia (increased calcium) in 116 patients (94.30%). Jaundice was the most common external sign, present in 98 patients (79.67%), while ascites were noted in 86 patients (69.91%). Death during the first decompensation occurred in 31 patients (25.20%), of whom 17 (54.83%) died in the hospital. The leading cause of mortality is bleeding from esophageal varices.  Conclusion Although a healthy liver performs over 200 distinct functions in the human body, a cirrhotic liver leads, one might say, to an even greater number of dysfunctions. This pathology is extremely complex, characterized by numerous complications and high treatment costs, which, despite all applied measures, do not ensure a favorable long-term prognosis without liver transplantation.