Assessment of Precipitating Factors and Outcomes of Hepatic Encephalopathy in Cirrhotic Patients

Abstract

Background: Hepatic encephalopathy (HE) is one of the major complications of liver cirrhosis (LC). It’s defined as a reversible neuropsychiatric event of liver cirrhosis. Up to fifty percent of cirrhotic patients will suffer from at least one attack of HE. Studies examining the prognostic significance of HE are limited despite the high prevalence in cirrhosis. The current study aimed to assess outcome of hepatic encephalopathy. Patients and methods: Over one year duration, 100 patients with HE were enrolled. All patients were subjected to full history taking and full examination. Patient with central nervous system lesion, metabolic disorders or post-ictal state was excluded. Abdominal ultrasound and ascitic fluid examination were performed in all patients. Patients were followed and their outcome was recorded. Results: Mean age of patients was 53.19 ±3.6 years and the majority of patients were males. Hepatitis C infection was the most frequent cause of LC. The main precipitating factor for HE was infection (29%) followed by hematemesis (24%) and constipation (19%). In 19 (19%) patients, there was evidence of ascitic fluid infection. Out of studied patients; 81 (81%) patients were alive. It was noticed that hematemesis and infection were significantly higher in dead patients. Conclusion: hepatic encephalopathy is a serious event in patients with LC. Major precipitating factors were infection, hematemesis and constipation. Infection and hematemesis are usually associated with poor outcome.