Original articlePancreas, biliary tract, and liverHepatic Encephalopathy Is Associated With Mortality in Patients With Cirrhosis Independent of Other Extrahepatic Organ Failures
Section snippets
Methods
The prospectively enrolled patients in NACSELD include patients with cirrhosis who are hospitalized for nonelective reasons. The diagnosis of cirrhosis was made using biopsy, endoscopic or radiological evidence of portal hypertension or cirrhosis, and/or signs of hepatic decompensation (HE, ascites, variceal bleeding, jaundice, and/or hepatorenal syndrome). Patients were excluded for human immunodeficiency virus, an unclear diagnosis of cirrhosis, a prior liver transplant, those who had an
Results
We enrolled 1576 patients; 13 had incomplete information regarding maximum HE grade and EHOF, and 7 had incomplete information regarding admission HE grade and EHOF. Therefore, for the maximum HE grade 1560 patients were studied, and 1569 were studied in the analysis of admission HE. The mean age was 57 ± 7 years, most of whom were men (64%). Prior HE on admission was present in 57% of patients, of whom 38% were on rifaximin therapy. Patients who had HE either on admission or those who
Discussion
With the changing landscape of cirrhosis complications, HE has emerged as one of the leading causes for hospitalization and readmission in patients with cirrhosis.1, 11, 12 Because HE can be precipitated by several important factors, such as infections, gastrointestinal bleeding, and electrolyte abnormalities, trends in HE management likely reflect the underlying approach to almost all important cirrhosis-associated reasons for hospitalization.5, 12
The issues with HE grade identification have
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Conflicts of interest These authors disclose the following: Jasmohan S. Bajaj has served as a consultant for Valeant, Grifols, Norgine, and Abbott. PJT, Jacqueline G. O’Leary, Florence Wong, Patrick S. Kamath, and K. Rajender Reddy have served as consultants for Grifols. The remaining authors disclose no conflicts.
Funding This study was partly supported by an investigator-initiated grant from Grifols Pharmaceuticals.