Factors Influencing the Outcome in Hepatic Encephalopathy Patients: Preventable Factors Worsen the Outcome

Abstract

Objective: To determine the factors that influence the outcome in terms of death or survival in patients who presented with hepatic encephalopathy in our tertiary care hospital.
Material and Methods: 13 This was a prospective observational study performed at Department of Medicine, Hepatology and Gastroen-terology, SIMS, Lahore, from June 2022 to May 2023. After written informed consents, patients who presented with hepatic encephalopathy were enrolled. Their demographic features and laboratory indices were noted. These patients were followed for the outcome in terms of death (group A) or no death (group B) during hospitalization. SPSS-27 was used for analysis. Independent sample T test and Chi-square test were used to compare two groups with quantitative and quantitative variables respectively.
The p-values were labelled significant if <0.05. The regression analysis was also executed to find the likelihood of worse outcome.
Results: Amongst 325 hepatic encephalopathy patients, 80.3%recoveredwhile 19.7%died during hospitalization. Age (p=0.924), weight (p=0.123), initial MELD score (p=0.943) and initial platelet count (p=0.977) were comparable in both groups. The occurrence of death had no significant association with gender (p=0.481), etiology of cirrhosis (p=0.592), HRS (p=0.592), and comorbidities (p=0.252). The death occurred 26.3 times more in patients who aspirated, 63.4 times more in who had no history of endoscopy, and 24.9 times more in who presented with upper GI bleed.
Conclusion: The inpatient mortality was significantly high in hepatic encephalopathy patients who got pulmonary aspiration, who presented with upper GI bleed, and who had no history of endoscopy. Age, gender, MELD score, etiology of cirrhosis, hepatorenal syndrome, and comorbidities did not significantly take part in the mortality of these patients.