Abstract
Hepatic encephalopathy (HE) is a common complication of liver failure that is associated with poor prognosis. However, the prognosis is not uniform and depends on the underlying liver disease. Acute liver failure is an uncommon cause of HE that carries bad prognosis but is potentially reversible. There are several prognostic systems that have been specifically developed for selecting patients for liver transplantation. In patients with cirrhosis the prognosis of the episode of HE is usually dictated by the underlying precipitating factor. Acute-on-chronic liver failure is the most severe form of decompensation of cirrhosis, the prognosis depends on the number of associated organ failures. Patients with cirrhosis that have experienced an episode of HE should be considered candidates for liver transplant. The selection depends on the underlying liver function assessed by the Model for End-stage Liver Disease (MELD) index. There is a subgroup that exhibits low MELD and recurrent HE, usually due to the coexistence of large portosystemic shunts. The recurrence of HE is more common in patients that develop progressive deterioration of liver function and hyponatremia. The bouts of HE may cause sequels that have been shown to persist after liver transplant.
Highlights
Hepatic encephalopathy (HE) is usually interpreted as a sign of liver failure and has ominous considera-tions
This article reviews the assessment of prognosis in patients with HE, based on the underlying liver disease and the severity of neurological manifestations
The importance of HE in determining the prognosis of patients with cirrhosis has been acknowledged in the most widely used system that assesses the severity of liver failure: the Child-Pugh scoring system
Summary
Hepatic encephalopathy (HE) is usually interpreted as a sign of liver failure and has ominous considera-. ), the prognosis of patients with HE is not uniform. Establishing the prognosis is difficult and requires a precise assessment of neurological and hepatic function [1]. HE is characterized by a myriad of neurological manifestations, diverse underlying liver disorders and a variety of precipitating factors [2]; all of them may affect prognosis. The approach to the patient with HE should be performed according to the underlying disorders, as is recognized in the classification (Table 1). This article reviews the assessment of prognosis in patients with HE, based on the underlying liver disease and the severity of neurological manifestations. The majority of studies have not classified the patients according to the type of liver disease and the availability of data in some areas is limited
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
