Patient Characteristics at Admission Affecting Short-term Outcome in Hepatic Encephalopathy: A Cross-sectional Study.

AIM AND BACKGROUND

To determine the factors that affect outcome in hospitalized patients of hepatic encephalopathy (HE).

MATERIALS AND METHODS

This was a cross-sectional observational study aimed at correlating the presenting patient profile with outcome in patients of chronic liver disease (CLD) HE; with 131 participants over 18 months. The primary outcome was mortality, and the secondary outcome was duration of hospital stay in surviving patients.

RESULTS

Hypoglycemia, hypoxia, abnormal total leukocyte count (TLC), %Neutrophils, S. Sodium, S. Chloride, S. Urea, S. Creatinine and aspartate transaminase (AST) levels, MELD-Na score, and the number of precipitating factors were associated with higher mortality (at ≤0.05). A prognostic index was calculated from seven parameters to predict mortality (area under curve AUC = 80.2%, sensitivity = 84.1%, specificity = 72.4% at cut-off 42). The mean duration of hospital stay was 4.3 (±4.5) days in patients who expired and 9.0 (±9.6) days in patients who recovered ( ≤ 0.05). Approximately 81.8 and 90.9% of deaths occurred within the first 3 and 10 days of admission, respectively.

CONCLUSION

The study identified readily available lab parameters that can be used to detect patients at high risk of mortality during hospitalization for HE. A prognostic score calculable from these parameters has also been proposed. Most of the deaths were found to occur during the initial days of hospital stay.

CLINICAL SIGNIFICANCE

The presentation and prognostic factors were different from those reported in Western literature. The identification of prognostic factors, and a high-risk early hospitalization period will help in the early detection and aggressive management of at-risk patients.

HOW TO CITE THIS ARTICLE

Singh H, Singh K, Kumar V, Patient Characteristics at Admission Affecting Short-term Outcome in Hepatic Encephalopathy: A Cross-sectional Study. Euroasian J Hepato-Gastroenterol 2025;15(1):68-71.