Clinico-etiological profile of ascites among adult patients attending a tertiary care hospital: a hospital-based cross-sectional study

Abstract

Background: Ascites is a common manifestation of several diseases and an important cause of hospitalization. Portal hypertension secondary to chronic liver disease remains the leading cause worldwide, although the etiological spectrum varies geographically. In India, tuberculosis, malignancy, and systemic disorders also contribute substantially. This study evaluated the clinical, laboratory, and etiological profile of adults presenting with ascites at a tertiary care hospital in Western India. Methods: A hospital-based cross-sectional study was conducted among 267 consecutive adults with ascites admitted to the Department of Medicine at a tertiary care hospital in Vadodara, Gujarat, over one year. Demographic characteristics, clinical presentation, laboratory parameters, ultrasonographic findings, and ascitic fluid analysis were recorded using a structured proforma. Data were analyzed using descriptive and inferential statistics, with p<0.05 considered statistically significant. Results: Among 267 participants, mean age was 53.7 ± 13.2 years and 181 (67.8%) were males. Chronic liver disease with portal hypertension was the commonest etiology (174; 65.2%), followed by malignancy (31; 11.6%), tuberculous peritonitis (24; 9.0%), congestive heart failure (17; 6.4%), nephrotic syndrome (11; 4.1%), pancreatitis (6; 2.2%), and miscellaneous causes (4; 1.5%). High-SAAG ascites was present in 191 (71.5%) patients and was significantly associated with portal hypertensive causes (p<0.001). Conclusion: Chronic liver disease remains the predominant cause of ascites, while tuberculosis and malignancy remain important non-cirrhotic etiologies. Clinical evaluation combined with ascitic fluid analysis, particularly SAAG, facilitates accurate etiological diagnosis and appropriate management.