Karim Masood Muhammad, Khalid Abdullah Bin, Sohail Zahabia, Yasrab Mohammad
Masood Muhammad Karim, Fellow, Aga Khan University Hospital, Karachi, Pakistan.
Abdullah Bin Khalid, Lecturer, Department of Medicine, Lecturer, Dow University of Health Science, Karachi, Pakistan, Aga Khan University Hospital, Karachi, Pakistan.
Pak J Med Sci. 2024 Jan-Feb;40(1Part-I):140-144. doi: 10.12669/pjms.40.1.8025.
Recurrent episodes of Portal Systemic Encephalopathy (PSE), poses a significant burden of illness on the patients and healthcare system. The objective of this study was to assess the recurrence of PSE in cirrhotic patients after index episode of PSE and to identify various risk factors associated with it.
A retrospective, single-centre study was conducted at Aga Khan University Hospital over a span of one year. Patients who were admitted first time with PSE and admitted within three months of index PSE were enrolled in the study. Variables assessed were demographic data, associated comorbid conditions, aetiology of cirrhosis, Child-Turcotte-Pugh (CTP) score, Model of End-Stage Liver Disease (MELD) score, PSE grade, laboratory tests, ascites with spontaneous bacterial peritonitis (SBP), variceal bleeding. Statistical analysis was done and variables of those who developed recurrence were compared with those who did not.
Fifty one patients were recruited. Thirty three (64.7%) were readmitted with PSE. On comparative analysis of both groups; infection, Meld score, low albumin, and raised total bilirubin showed significant P-value (<0.05).
Identification of risk factors during assessment can reduce the recurrence of PSE. We would recommend to validate result of our study on a large scale prospectively.
门体系统性脑病(PSE)的反复发作给患者和医疗系统带来了沉重的疾病负担。本研究的目的是评估肝硬化患者在首次发生PSE后PSE的复发情况,并确定与之相关的各种危险因素。
在阿迦汗大学医院进行了一项为期一年的回顾性单中心研究。首次因PSE入院且在首次PSE发作后三个月内入院的患者被纳入研究。评估的变量包括人口统计学数据、相关合并症、肝硬化病因、Child-Turcotte-Pugh(CTP)评分、终末期肝病模型(MELD)评分、PSE分级、实验室检查、伴有自发性细菌性腹膜炎(SBP)的腹水、静脉曲张出血。进行了统计分析,并将复发患者的变量与未复发患者的变量进行了比较。
招募了51名患者。33名(64.7%)患者再次因PSE入院。对两组进行比较分析;感染、Meld评分、低白蛋白和总胆红素升高显示出显著的P值(<0.05)。
在评估过程中识别危险因素可以降低PSE的复发率。我们建议前瞻性地大规模验证我们的研究结果。