Hepatic encephalopathy- Clinical profile and patient outcome

Abstract

Background: Hepatic Encephalopathy (HE) is a challenging and prevalent complication that arises in the context of liver cirrhosis characterized by cognitive dysfunction resulting from liver insufficiency and/or the development of portosystemic shunts. Aim and Objectives: To investigate the clinical characteristics, precipitating factors, and clinical outcomes of HE with liver disease in patients admitted to a tertiary care center. Material and Methods: A retrospective observational study at a hospital reviewed records of 100 HE patients admitted from Jan-Dec 2022. Data on demographics, clinical features, lab results, stay duration, and outcomes were collected from past records. Statistical analysis explored links between outcomes, symptoms, lab results, causes, Model for End-Stage Liver Disease (MELD) scores, and hospital duration (p < 0.05 considered significant). Patients were tracked until discharge or death. Results: Most HE cases were males (75.8%) and aged 21-87. Key symptoms were abdominal distension (62.6%) and jaundice (60.4%). Jaundice impacted outcomes (p = 0.045); infections triggered 39.6% of cases, impacting outcomes (p = 0.039). High direct bilirubin levels affected prognosis (p = 0.000). Alcohol-related liver disease was the main cause (41.8%). Higher MELD scores were linked to worse outcomes; etiology and hospitalization duration (p = 0.138) had no significant effect on outcomes. Conclusion: This study provides valuable insights into HE in liver disease patients, facilitating early detection and effective management to reduce mortality and morbidity rates.

Keywords

• hepatic encephalopathy
• liver disease
• jaundice
• alcohol dependence
• model for end-stage liver disease
• clinical characteristics
• precipitating factors