Predictors of treatment response in cirrhotic patients with overt hepatic encephalopathy

Treatment response in hepatic encephalopathy

Authors

Keywords:

Hepatic Encephalopathy, Liver Cirrhosis, Predictors, Response

Abstract

Introduction: Hepatic encephalopathy (HE) is a frequent complication and one of the most debilitating manifestations of liver cirrhosis, which negatively impacts patient survival. This study aims to identify the factors influencing the treatment response in patients with liver cirrhosis and HE.

Method: This was a prospective observational study conducted from July 2019 to June 2020 in a tertiary referral center in Nepal. The ethical clearance was obtained from the Institutional Review Board of the center (Reference No. 46/076/77). Patients with Liver cirrhosis with HE grade II or more were included. Standard medical therapy for HE was given to all the patients, and treatment response for the first five days post admission was recorded. The response was categorized as a good response, no response, and deterioration, based on improvement or deterioration of the patient`s symptoms or changes in West Haven criteria.

Result: In this study total of 78 patients were enrolled and included in the final analysis. The mean age was 50.17± 10.36 years and 63(80.76%) were male. Alcohol was the etiology of cirrhosis in 62(79.5%). Seventy-two (92.3%)  patients had a good response to the treatment, 3(3.8 %) of patients had no response, and the rest 3(3.8%) deteriorated. On logistic regression, high creatinine, high bilirubin, and low serum protein were the predictors of non-response to standard therapy (p<0.05).

Conclusion: High serum creatinine, high bilirubin, and low serum protein were the predictors of non-response to standard therapy in patients with Liver Cirrhosis with Hepatic Encephalopathy.

Keywords: Hepatic encephalopathy, liver cirrhosis, predictors, response

Author Biographies

Roshan Shrestha, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Assistant Professor, Department of Internal Medicine, Patan Hospital

Sanjit Karki, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Assistant Professor, Department of Internal Medicine, Patan Hospital

Manoj Sah, National Academy of Medical Sciences, Kathmandu, Nepal

Professor, Department of Gastroenterology, Bir Hospital

Nandu Silwal Poudel, National Academy of Medical Sciences, Kathmandu, Nepal

Associate Professor, Department of Gastroenterology, Bir Hospital

Ajit Khanal, National Academy of Medical Sciences, Kathmandu, Nepal

Professor, Department of Gastroenterology, Bir Hospital

Binod Karki, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal

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Published

2022-09-17

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Section

General - Original Articles