Type and etiology of liver cirrhosis are not related to the presence of hepatic encephalopathy or health-related quality of life: a cross-sectional study.

Evangelos Kalaitzakis,Axel Josefsson,Einar Björnsson

doi:10.1186/1471-230x-8-46

Evangelos Kalaitzakis, Axel Josefsson + Show 1 more

Open Access

https://doi.org/10.1186/1471-230x-8-46

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Journal: BMC gastroenterology	Publication Date: Oct 15, 2008
Citations: 60	License type: CC BY 2.0

Affiliation: Sahlgrenska University Hospital

Abstract

BackgroundHepatic encephalopathy has a negative impact on health-related quality of life (QoL) in liver cirrhosis. There are scarce and conflicting data on whether type or etiology of liver cirrhosis could be related to hepatic encephalopathy in patients with cirrhosis. We aimed to determine the impact of cirrhosis etiology on hepatic encephalopathy and whether hepatic encephalopathy affects health-related QoL among patients with cirrhosis of different etiologies.MethodsA total of 156 cirrhotic patients were prospectively evaluated for the presence of hepatic encephalopathy according to the West-Haven criteria as well as by means of two psychometric tests. Patients with cryptogenic cirrhosis or cirrhosis due to mixed hepatocellular/cholestatic etiologies were excluded. Fasting plasma glucose levels were also measured. QoL was evaluated by means of a validated questionnaire (SF-36).ResultsDiabetes mellitus was more common in patients with hepatocellular cirrhosis compared to those with cholestatic cirrhosis but the two groups did not differ in cirrhosis severity or the prevalence of hepatic encephalopathy (p > 0.05). The groups of patients with cirrhosis due to alcohol, hepatitis C, or cholestatic liver disease did not differ in severity of liver cirrhosis or the prevalence of hepatic encephalopathy (p > 0.05). Patients with cirrhosis of different etiologies did not differ in any SF-36 domain (p > 0.05). In multivariate analysis, performance at neuropsychological testing was independently related only to age, diabetes mellitus, and the Child-Pugh score whereas the SF-36 physical component summary only to the Child-Pugh score and hepatic encephalopathy.ConclusionCirrhosis etiology does not seem to be related to hepatic encephalopathy or health-related QoL. Cognitive impairment is associated mainly with age, liver disease severity and diabetes mellitus.

Highlights

Hepatic encephalopathy has a negative impact on health-related quality of life (QoL) in liver cirrhosis
We aimed to evaluate the relation of etiology of liver disease with health-related QoL
Hepatic encephalopathy in hepatocellular vs. cholestatic cirrhosis Diabetes mellitus was less common among patients with cholestatic cirrhosis compared to those with hepatocellular cirrhosis but the two groups did not differ significantly in the prevalence of hepatic encephalopathy nor in the prevalence of other complications or in severity of liver cirrhosis

Summary

Introduction

Hepatic encephalopathy has a negative impact on health-related quality of life (QoL) in liver cirrhosis. There are scarce and conflicting data on whether type or etiology of liver cirrhosis could be related to hepatic encephalopathy in patients with cirrhosis. Diabetes mellitus was found to be associated with HE in hepatitis C cirrhosis [5] and with performance at neuropsychological cognitive testing in an unselected cirrhotic population [6]. The prevalence of diabetes mellitus is known to vary according to the etiology of cirrhosis, being higher in patients with cirrhosis due to hepatitis C or alcoholic liver disease (hepatocellular disease) compared to patients with cirrhosis due to cholestatic liver disease [7]. It is unknown whether any potential difference in the prevalence of HE between cholestatic and hepatocellular cirrhosis can be explained by the different prevalence of diabetes mellitus in these groups of patients

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