International normalized ratio and model for end-stage liver disease score for predicting short-term prognosis of cirrhotic patients with hepatic encephalopathy

Abstract

Objective To determine the predictors of early readmission (30 d) and mid-term mortality (6 months) in cirrhotic patients discharged after hepatic encephalopathy (HE) is controlled. Methods A total of 213 cirrhotic patients with HE, who were discharged after HE was controlled, were enrolled in the study and followed up for 6 months. The early readmission within 30 d after discharge and the mid-term (in 6 months) mortality of the patients were recorded, and the predictors of the short-term prognosis were analyzed. Results The international normalized ratio (INR) [odds ratio (OR)=2.40, P=0.003] at discharge independently predicted the early readmission of the patients. The incidence of early readmission was significantly higher in patients with an INR>1.62 at discharge than in those with an INR ≤1.62 (44% vs 20%, Chi-square=14.335, P < 0.001). The model for end-stage liver disease (MELD) score at discharge was an independent predictor of early readmission associated with HE (OR=1.11, P=0.048). Hemoglobin at discharge was an independent predictor of non-early readmission (OR=0.97, P=0.005). The use of an artificial liver during the first hospitalization independently predicted the mid-term mortality of the patients after discharge [hazard ratio (HR)=6.67, P=0.021]. Conclusion For cirrhotic patients with HE, INR can be applied to identify those at a high risk of early readmission, and MELD score is capable of predicting early relapse of HE after discharge.

Keywords

• international normalized ratio
• model for end-stage liver disease
• liver cirrhosis
• hepatic encephalopathy
• prognosis
• prospective study
• multivariate analysis