Duration of the acute hepatic encephalopathy episode determines survival in cirrhotic patients
Background: Episodes of hepatic encephalopathy (HE) have been related to low survival rate. However, the relation between its clinical evolution and mortality has not been assessed. Methods: A retrospective analysis of 245 cirrhotic patients admitted for an acute episode of HE (⩾grade 2) or who deve...
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doaj-a5ec5ad7412041b0a757d96dd00c55e32020-11-25T03:15:28ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482018-01-011110.1177/1756283X17743419Duration of the acute hepatic encephalopathy episode determines survival in cirrhotic patientsMeritxell Ventura-CotsIsabel CarmonaCarolina MorenoJavier AmpueroMacarena Simón-TaleroFrancesc SanpedroIñigo LesManuel Romero-GómezJoan GenescàBackground: Episodes of hepatic encephalopathy (HE) have been related to low survival rate. However, the relation between its clinical evolution and mortality has not been assessed. Methods: A retrospective analysis of 245 cirrhotic patients admitted for an acute episode of HE (⩾grade 2) or who developed an HE episode after an upper gastrointestinal bleeding (UGIB) event was performed to assess the relation between time in HE and transplant-free survival. Results: Median (IQR 25–75 ) time in HE was 48 h (24–96 h) in the whole cohort. Patients who presented a longer time in HE (>48 h; n = 89) exhibited a lower transplant-free survival at 28 days (67.2% versus 88.9%, p < 0.001), 90 days (48.7% versus 73.8%, p < 0.001) and 365 days (30.3% versus 53.2%, p < 0.001), as compared to those with less time in HE (⩽48 h; n = 156). Survival rates remained significantly different, with lower percentages in the group with time in HE >48 h, when comparing patients according to baseline HE grade (2 versus ⩾3) or model for end-stage liver disease (MELD) function (⩽15 versus >15). Time in HE was also an independent risk factor for mortality at each time point, hazard ratio (HR) (95 CI%) 28 days 2.59 (1.39–4.84); 90 days 1.98 (1.28–3.1) and 365 days 1.5 (1.08–2.19). Conclusions: The duration of the acute HE episode determines survival in cirrhotic patients independently of liver function and baseline HE grade.https://doi.org/10.1177/1756283X17743419 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Meritxell Ventura-Cots Isabel Carmona Carolina Moreno Javier Ampuero Macarena Simón-Talero Francesc Sanpedro Iñigo Les Manuel Romero-Gómez Joan Genescà |
spellingShingle |
Meritxell Ventura-Cots Isabel Carmona Carolina Moreno Javier Ampuero Macarena Simón-Talero Francesc Sanpedro Iñigo Les Manuel Romero-Gómez Joan Genescà Duration of the acute hepatic encephalopathy episode determines survival in cirrhotic patients Therapeutic Advances in Gastroenterology |
author_facet |
Meritxell Ventura-Cots Isabel Carmona Carolina Moreno Javier Ampuero Macarena Simón-Talero Francesc Sanpedro Iñigo Les Manuel Romero-Gómez Joan Genescà |
author_sort |
Meritxell Ventura-Cots |
title |
Duration of the acute hepatic encephalopathy episode determines survival in cirrhotic patients |
title_short |
Duration of the acute hepatic encephalopathy episode determines survival in cirrhotic patients |
title_full |
Duration of the acute hepatic encephalopathy episode determines survival in cirrhotic patients |
title_fullStr |
Duration of the acute hepatic encephalopathy episode determines survival in cirrhotic patients |
title_full_unstemmed |
Duration of the acute hepatic encephalopathy episode determines survival in cirrhotic patients |
title_sort |
duration of the acute hepatic encephalopathy episode determines survival in cirrhotic patients |
publisher |
SAGE Publishing |
series |
Therapeutic Advances in Gastroenterology |
issn |
1756-2848 |
publishDate |
2018-01-01 |
description |
Background: Episodes of hepatic encephalopathy (HE) have been related to low survival rate. However, the relation between its clinical evolution and mortality has not been assessed. Methods: A retrospective analysis of 245 cirrhotic patients admitted for an acute episode of HE (⩾grade 2) or who developed an HE episode after an upper gastrointestinal bleeding (UGIB) event was performed to assess the relation between time in HE and transplant-free survival. Results: Median (IQR 25–75 ) time in HE was 48 h (24–96 h) in the whole cohort. Patients who presented a longer time in HE (>48 h; n = 89) exhibited a lower transplant-free survival at 28 days (67.2% versus 88.9%, p < 0.001), 90 days (48.7% versus 73.8%, p < 0.001) and 365 days (30.3% versus 53.2%, p < 0.001), as compared to those with less time in HE (⩽48 h; n = 156). Survival rates remained significantly different, with lower percentages in the group with time in HE >48 h, when comparing patients according to baseline HE grade (2 versus ⩾3) or model for end-stage liver disease (MELD) function (⩽15 versus >15). Time in HE was also an independent risk factor for mortality at each time point, hazard ratio (HR) (95 CI%) 28 days 2.59 (1.39–4.84); 90 days 1.98 (1.28–3.1) and 365 days 1.5 (1.08–2.19). Conclusions: The duration of the acute HE episode determines survival in cirrhotic patients independently of liver function and baseline HE grade. |
url |
https://doi.org/10.1177/1756283X17743419 |
work_keys_str_mv |
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