A Hospital-Based Study to Assess the Role and Efficacy of Biochemical Testing in Diagnosing the Cause of Fluid Accumulation

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Abstract (English)

Abstract
Aim: The aim of the present study was to examine role and efficacy of biochemical testing in diagnosing the
cause of fluid accumulation.
Methods: The observational hospital-based study was carried out at Department of Biochemistry, Anugrah
Narayan Magadh Medical College and Hospital (ANMMCH) Gaya, Bihar, India for one year. Data was taken
from medical records department. All 100 indoor patients who were diagnosed as ascites on the basis of history,
physical examination, ultrasonography, and of age >18 years were included in the study after getting the
informed consent. Patients who had a diagnostic paracentesis within 2 weeks (cause was already established),
secondary cause of peritonitis and unwilling to participate in the study were excluded.
Results: This study included 100 patients with age ranging from 20 to 78 years and majority of patients were
aged between 41-50 years (n=24, 24%), only 9 patients 9% admitted with ascites of the age group between 18-
30 years. 62 patients (62%) were male and 38 patients (38%). The most common clinical feature was abdominal
discomfort, followed by Anorexia, Icterus, Splenomegaly and Hepatomegaly. The most common etiology of
Ascites was Liver cirrhosis (39%), followed by Tuberculosis (33%) then Malignancy (9%), and Congestive
Heart Failure (6%). The least common etiology of Ascites was Hypothyroidism (3%). 40 of the 60 exudates
were detected using the traditional cutoff for cell count greater than 500/mm3, but using the cutoff proposed in
the present paper (300 cells/mm3), the detection increased to 49/60. Of the biochemical parameters studied, the
AST ratio AF/S (> 0.5) detected the greater number of exudates correctly classified 48/60, while 7 of 40
transudates were falsely classified.
Conclusion: Ascites due to chronic liver disease was the main finding with etiology supported by laboratory
findings. Biochemical testing of peritoneal and pleural fluids is carried out widely, although the range of tests
likely to be useful is limited in comparison to the repertoire of tests available in a modern biochemistry
laboratory