Prognostic Significance of Hypokalemia on Length of Hospital Stay in Patients with Hepatic Encephalopathy

Abstract

Background: Patients with cirrhosis may have either a chronic neuropsychiatric state due to portal-systematic shunting or have an acute episode with some precipitating factor labeled as hepatic encephalopathy. In patients with encephalopathy, hypokalemic alkalosis leads to an increase in the amount of nonionic ammonia that readily crosses the blood brain barrier and accumulates in the CNS that can worsen the disease. Objective: The purpose of the study was to determine the frequency of hypokalemia in patients with hepatic encephalopathy and to compare the length of the hospital stay in hepatic encephalopathy patients with and without hypokalemia. Study type, settings & duration: This cross sectional study was conducted at Jinnah Postgraduate Medical Centre, Karachi from February to July 2021. Methodology: The sample was calculated by using WHO sample size calculator at 95% confidence interval and absolute precision of 8% with anticipated population proportion of 35%. The sample was recruited by using non-probability consecutive sampling technique. Hepatic encephalopathy was diagnosed on basis of clinical examination by West Haven Classification grades. Patients were diagnosed for hypokalemia by hospital lab as having potassium levels <3.5 meq/L. The information was recorded on proformas and data was analyzed. Results: The mean serum potassium level was 3.49 ±0.51 mmol/L, frequency of hypokalemia was observed in 48 (35%) participants. The mean length of hospital stay was 5.86 ±1.18 days. There was no any association between hypokalemia and prolonged hospital stay (p-value =0.394). Conclusion: The frequency of hypokalemia was observed in 35% patients with hepatic encephalopathy. However, there ..........

Keywords

• Hypokalemia
• hepatic encephalopathy
• frequency
• hospital stay