Frontiers in Medicine (Aug 2021)
Impact of Hepatic Encephalopathy on Clinical Characteristics and Adverse Outcomes in Prospective and Multicenter Cohorts of Patients With Acute-on-Chronic Liver Diseases
- Liyuan Long,
- Hai Li,
- Hai Li,
- Hai Li,
- Guohong Deng,
- Guohong Deng,
- Xianbo Wang,
- Xianbo Wang,
- Sihong Lu,
- Beiling Li,
- Zhongji Meng,
- Zhongji Meng,
- Yanhang Gao,
- Yanhang Gao,
- Zhiping Qian,
- Zhiping Qian,
- Feng Liu,
- Feng Liu,
- Feng Liu,
- Xiaobo Lu,
- Xiaobo Lu,
- Haotang Ren,
- Jia Shang,
- Hai Li,
- Shaoyang Wang,
- Yubao Zheng,
- Yubao Zheng,
- Huadong Yan,
- Huadong Yan,
- Shan Yin,
- Shan Yin,
- Wenting Tan,
- Qun Zhang,
- Xin Zheng,
- Xin Zheng,
- Jinjun Chen,
- Jinjun Chen,
- Sen Luo,
- Jinming Zhao,
- Wei Yuan,
- Tao Li,
- Rongjiong Zheng,
- Junping Liu,
- Xiaoxiao Liu,
- Wenyi Gu,
- Wenyi Gu,
- Sumeng Li,
- Xue Mei,
- Ruochan Chen,
- Yan Huang,
- Yan Huang
Affiliations
- Liyuan Long
- Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha, China
- Hai Li
- Department of Gastroenterology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, Shanghai, China
- Hai Li
- Key Laboratory of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Chinese Ministry of Health (Shanghai Jiao Tong University), Shanghai, China
- Hai Li
- Chinese Chronic Liver Failure (CLIF) Consortium, Shanghai, China
- Guohong Deng
- Chinese Chronic Liver Failure (CLIF) Consortium, Shanghai, China
- Guohong Deng
- Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Xianbo Wang
- Chinese Chronic Liver Failure (CLIF) Consortium, Shanghai, China
- Xianbo Wang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Sihong Lu
- Department of Infectious Diseases, Institute of Infection and Immunology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
- Beiling Li
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Zhongji Meng
- Chinese Chronic Liver Failure (CLIF) Consortium, Shanghai, China
- Zhongji Meng
- Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, Shiyan, China
- Yanhang Gao
- Chinese Chronic Liver Failure (CLIF) Consortium, Shanghai, China
- Yanhang Gao
- 0Department of Hepatology, The First Hospital of Jilin University, Changchun, China
- Zhiping Qian
- Chinese Chronic Liver Failure (CLIF) Consortium, Shanghai, China
- Zhiping Qian
- 1Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, China
- Feng Liu
- Chinese Chronic Liver Failure (CLIF) Consortium, Shanghai, China
- Feng Liu
- 2Department of Hepatology, Tianjin Institute of Hepatology, Nankai University Second People's Hospital, Tianjin, China
- Feng Liu
- 3Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan, China
- Xiaobo Lu
- Chinese Chronic Liver Failure (CLIF) Consortium, Shanghai, China
- Xiaobo Lu
- 4Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
- Haotang Ren
- 5State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Jia Shang
- 6Department of Infectious Diseases, Henan Provincial People's Hospital, Zhengzhou, China
- Hai Li
- 7Department of Infectious Diseases, Affiliated Hospital of Logistics University of People's Armed Police Force, Tianjin, China
- Shaoyang Wang
- 8Department of Infectious Diseases, Fuzhou General Hospital of Nanjing Military Command, Fuzhou, China
- Yubao Zheng
- Chinese Chronic Liver Failure (CLIF) Consortium, Shanghai, China
- Yubao Zheng
- 9Department of Infectious Diseases, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Huadong Yan
- Chinese Chronic Liver Failure (CLIF) Consortium, Shanghai, China
- Huadong Yan
- 0Department of Hepatology, Ningbo No. 2 Hospital, Ningbo, China
- Shan Yin
- Department of Gastroenterology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shan Yin
- Key Laboratory of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Chinese Ministry of Health (Shanghai Jiao Tong University), Shanghai, China
- Wenting Tan
- Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Qun Zhang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Xin Zheng
- Chinese Chronic Liver Failure (CLIF) Consortium, Shanghai, China
- Xin Zheng
- Department of Infectious Diseases, Institute of Infection and Immunology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
- Jinjun Chen
- Chinese Chronic Liver Failure (CLIF) Consortium, Shanghai, China
- Jinjun Chen
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Sen Luo
- Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, Shiyan, China
- Jinming Zhao
- 0Department of Hepatology, The First Hospital of Jilin University, Changchun, China
- Wei Yuan
- 1Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, China
- Tao Li
- 3Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan, China
- Rongjiong Zheng
- 4Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
- Junping Liu
- 6Department of Infectious Diseases, Henan Provincial People's Hospital, Zhengzhou, China
- Xiaoxiao Liu
- Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha, China
- Wenyi Gu
- Department of Gastroenterology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, Shanghai, China
- Wenyi Gu
- Key Laboratory of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Chinese Ministry of Health (Shanghai Jiao Tong University), Shanghai, China
- Sumeng Li
- Department of Infectious Diseases, Institute of Infection and Immunology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
- Xue Mei
- 1Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, China
- Ruochan Chen
- Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha, China
- Yan Huang
- Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha, China
- Yan Huang
- Chinese Chronic Liver Failure (CLIF) Consortium, Shanghai, China
- DOI
- https://doi.org/10.3389/fmed.2021.709884
- Journal volume & issue
-
Vol. 8
Abstract
Importance: Hepatic encephalopathy is a severe complication, and its contribution to clinical adverse outcomes in patients with acute-on-chronic liver diseases from the East is unclear.Objective: We aimed to investigate the impact of hepatic encephalopathy on clinical characteristics and adverse outcomes in prospective and multicenter cohorts of patients with acute-on-chronic liver diseases.Design: We conducted a cohort study of two multicenter prospective cohorts.Setting: China.Participants: Acute-on-chronic liver disease patients with various etiologies.Exposure: The diagnosis and severity of hepatic encephalopathy were assessed using the West Haven scale.Main Outcome Measure: The correlation between clinical adverse outcomes and varying hepatic encephalopathy grades was analyzed in the target patients.Results: A total of 3,949 patients were included, and 340 of them had hepatic encephalopathy. The incidence of hepatic encephalopathy was higher in patients with alcohol consumption (9.90%) than in those with hepatitis B virus infection (6.17%). The incidence of 28- and 90-day adverse outcomes increased progressively from hepatic encephalopathy grades 1–4. Logistic regression analysis revealed that hepatic encephalopathy grades 3 and 4 were independent risk factors for the 28- and 90-day adverse outcome in the fully adjusted model IV. Stratified analyses showed similar results in the different subgroups. Compared to grades 1–2 and patients without hepatic encephalopathy, those with grade 3 hepatic encephalopathy had a significant increase in clinical adverse outcomes, independent of other organ failures.Conclusions and Relevance: Hepatic encephalopathy grades 3–4 were independent risk factors for 28- and 90-day adverse outcomes. Hepatic encephalopathy grade 3 could be used as an indicator of brain failure in patients with acute-on-chronic liver disease.
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