Frequency of Different Precipitating Factors of Hepatic Encephalopathy in Patients with Cirrhosis of Liver Based on Child Class (original) (raw)
Related papers
2017
Cirrhosis of liver is a common chronic clinical entity. Hepatic encephalopathy is one of its frequent complication. Often there is an underlying precipitating factor which leads on to encephalopathy. Identifying and managing these factors will improve the quality of life of such patients. Aim: To study patients admitted with hepatic encephalopathy secondary to cirrhosis of liver and to evaluate for the known precipitants. Material and methods: Over a period of one and half year various factors precipitating hepatic encephalopathy in 50 patients with liver cirrhosis were evaluated. Patients were verified for fulfilling inclusion criteria and ruled out for presence of exclusion criteria. Grading of hepatic encephalopathy was done by West Haven Classification and prognostic stratification through Child Pugh score. Results: Gastrointestinal bleed as a precipitant of hepatic encephalopathy was noted among 60% of patients. Other precipitants include constipation, binge alcohol intake, ele...
Journal of the Pakistan Medical Association
To determine the precipitating factors of hepatic encephalopathy (HE) in patients with liver cirrhosis at Liaquat University Hospital Hyderabad/Jamshoro. This hospital based descriptive study was conducted from April 2007 to September 2007. All the patients who were more than 12 years of age and were diagnosed as hepatic encephalopathy were studied. During this period, 87 patients of hepatic encephalopathy were admitted. All patients were carefully examined, relevant investigations were performed and data was collected through pre-designed proforma. Male patients were 65 (75%), above 40 years of age 58 (67%), belonging to interior/periphery of Sindh 54 (62%), in grade IV of hepatic encephalopathy 70 (80%) and Anti-HCV positive were 52 (60%). The most common precipitating factors detected were infection 58 (67%), constipation 43 (49%) and gastrointestinal bleeding 39 (45%). Out of 87 patients, 68 had increased total leucocytes count, 09 patients had hypokalaemia, 24 patients, hyponat...
Hepatic Encephalopathy in Liver Cirrhosis: Precipitating factor and Outcome
Journal of Nepalgunj Medical College, 2019
Introduction: Hepatic encephalopathy, one of the major decompensating events of liver cirrhosis manifest as a wide spectrum of neurological or psychiatric abnormalities ranging from subclinical alterations to coma. The main aim of this study was to determine precipitants of hepatic encephalopathy (HE) and their impact on hospital stay and mortality. Methods: A hospital based cross-sectional study carried out in the Department of Medicine, Nepalgunj Medical College, Kohalpur from September 2018 to May 2019. Patients of liver cirrhosis with signs and symptoms of hepatic encephalopathy (HE) were enrolled in the study. Detailed history was taken with patients or patient's visitor regarding precipitating factors. Child Turcotte Pugh (CTP) class was used for assessing liver disease severity and West Haven classification was used for grading of hepatic encephalopathy. Results: Total patients of hepatic encephalopathy studied were 150. Among which, 114 (76%) were male and 36 (24%) were ...
Clinical Spectrum of Precipitating Factors of Hepatic Encephalopathy in Cirrhosis of the Liver
IOSR Journals , 2019
Background and Objectives: Hepatic encephalopathy is an extra hepatic complication of impaired liver function and is manifested as neuropsychiatric signs and symptoms associated with acute or chronic liver disease in the absence of other neurological disorders. This study aims to ascertain the spectrum of precipitating factors of hepatic encephalopathy in patients with cirrhosis of the liver. Methods: 100 cases of cirrhosis of the liver who presented in hepatic encephalopathy admitted to Sri Venkateswara Ramnarain Ruia Government General Hospital(SVRRGGH) ,Tirupati between may 2017 and april 2018 were studied. All patients of more than 18 years of age, manifesting with signs of hepatic encephalopathy were included, and those who had acute fulminant hepatitis or non cirrhotic portal hypertension were excluded from the study. Detailed history, clinical examination and thorough investigations were done to look for any precipitating factor and the findings were recorded on a proforma and prognostic stratification through Child-Pugh score was done. Results: Out of 100 patients, Upper GI bleed (51%), Constipation (41%), Electrolyte imbalance (38%) and Infection (22%) stood out as the most common precipitating factors. Usage of diuretics, sedatives, and excess dietary protein were the other factors. Most patients were in grade III (30%) and grade IV (37%) of hepatic encephalopathy. Other common associations were Child Pugh class C (67%), mortality (37%), and Alcoholism (54%). Interpretation and Conclusion: Upper GI bleed, Constipation, Infection, and Electrolyte imbalance were the most common precipitating factors of Hepatic encephalopathy in this study.
Precipitating factors of hepatic encephalopathy at a tertiary care hospital Jamshoro, Hyderabad
JPMA. The journal of the …, 2009
According to auspices of the World Congress of Gastroenterology, there are four types of hepatic encephalopathy (a) Acute, (b) Recurrent (c) Persistent (d) Minimal or sub-clinical. The hepatic encephalopathy is a diagnosis of exclusion 6 and has four grades. There are several precipitating factors for HE such as infection, gastrointestinal 683 J Pak Med Assoc Original Article Precipitating factors of hepatic encephalopathy at a tertiary care hospital Jamshoro, Hyderabad Abstract Objective: To determine the precipitating factors of hepatic encephalopathy (HE) in patients with liver cirrhosis at Liaquat University Hospital Hyderabad/Jamshoro. Methods: This hospital based descriptive study was conducted from April 2007 to September 2007. All the patients who were more than 12 years of age and were diagnosed as hepatic encephalopathy were studied. During this period, 87 patients of hepatic encephalopathy were admitted. All patients were carefully examined, relevant investigations were performed and data was collected through pre-designed proforma. Results: Male patients were 65 (75%), above 40 years of age 58 (67%), belonging to interior/periphery of Sindh 54 (62%), in grade IV of hepatic encephalopathy 70 (80%) and Anti-HCV positive were 52 (60%). The most common precipitating factors detected were infection 58 (67%), constipation 43 (49%) and gastrointestinal bleeding 39 (45%). Out of 87 patients, 68 had increased total leucocytes count, 09 patients had hypokalaemia, 24 patients, hyponatraemia, 64 hypoalbuminaemia and 54 patients had a disturbed coagulation profile. Fifty nine patients recovered and were discharged while 20 patients expired. Majority of expired patients had Child-Pugh score 10-15 and were in grade IV of hepatic encephalopathy. Conclusion: The study concluded that there were different factors which play a key role in hepatic encephalopathy. In these factors, infection was the most common (JPMA 59:683; 2009).
Hepatic encephalopathy in liver cirrhosis
Journal of Translational Internal Medicine
Liver cirrhosis is a worldwide gastroenterological condition, characterized by a slow, progressive and irreversible replacement of liver cells by fibrous tissue (scar) that prevents liver function. This condition often leads to the development of other syndromes. Cardiac complications can be indicated through abnormal QTc interval and arrhythmias, thereby their analysis aids in the prevention of cardiovascular events. Most cirrhotic cases have abnormal laboratory values (bilirubin, albumin, AST, ALT, AST/ALT, INR) indicating the presence of concomitant infection, inflammation and coagulopathy. In this case report, the usage Halstead-Reitan and Child-Pugh score helped in the assessment of the status of deterioration of brain. The knowledge of liver cirrhosis aetiologies help to determine the predisposition to development of hepatic encephalopathy and cardiomyopathy. The different values of liver enzymes and other blood laboratory analyses indicated the level of liver damage and poor ...
Introduction: Doctors in hospital practice often face chronic liver disease (CLD). Hepatic encephalopathy is a serious complication of chronic liver disease, most commonly in people with advanced cirrhosis. In patients with stable cirrhosis, hepatic encephalopathy is often followed by easily identifiable triggering events. The aim of the study is to understand the triggering factors and their frequency in CLD patients with hepatic encephalopathy in order to prevent mortality and morbidity. Methods: This descriptive observational study was conducted to identify triggers and their frequency among 50 cases of diagnosed chronic liver disease with hepatic encephalopathy at the Medicine department of Jalalabad Ragib-Rabeya Medical College & Hospital, Bangladesh for one-year duration from March 2019 to March 2020. Results: Among 50 patients, 36 patients (72%) were men, 14 (28%) women. The study found that the incidence of age 14 (28%) was 41 to 50 years, and 08 (16%) 51 to 60 years, 12 (24%)> 60 years. Of the 50 patients, the etiology of cirrhosis was hepatitis B virus in 28 (56%), hepatitis C virus in 4 (8%), both hepatitis B and C in 02 (4%). Among 50 patients 13 (26 %)) were grade 3 and 11 (22%) in grade 2 hepatic encephalopathy. According to Child-Pugh with a score of 16 (32%) in class C and 09 (18%) in class B. The most common triggers were gastrointestinal bleeding (28%), infection (26%), mixed (16%) and unknown (20%). In this study, the mortality rate was 32% of the majority of patients in Child-Pugh Class C. Conclusions: The most common triggers of hepatic encephalopathy in this study were the upper G.I. bleeding, infection, mixed factor and electrolyte imbalance. To prevent hepatic encephalopathy, caution should be exercised in administering diuretics to patients with chronic liver disease. Maintaining early and effective infection control measures and better hygiene conditions in government hospitals are imperative.
Postgraduate Medical Journal of Ghana
Background: Hepatic encephalopathy (HE) is one of the most debilitating complications of cirrhosis leading to death and severely affects the lives of patients and their caregivers. Decreases in HE mortality and recurrence have been linked with timely identification and correction of potential precipitating factors and early treatment. The aim of this study was therefore to determine the prevalence and precipitating factors of patients with cirrhotic ascites admitted with overt hepatic encephalopathy at KBTH Accra, Ghana.Materials and Methods: A cross-sectional study was conducted involving one hundred and three (103) patients admitted at medical block in the Korle-Bu Teaching Hospital (KBTH) with cirrhotic ascites from 25th March 2016 to 25th November, 2016. Demographic and clinical features including features of overt hepatic encephalopathy and possible precipitant were collected using a standardized questionnaire. Results: One hundred and three patients with cirrhotic ascites were...
Precipitating Factors and The Outcome of Hepatic Encephalopathy in Liver Cirrhosis
2010
To determine precipitants of hepatic encephalopathy (HE) and their impact on hospital stay and mortality. Study Design: Cross-sectional, analytical study. Place and Duration of Study. The precipitants of HE were correlated with the different grades of HE, and length of hospital stay and mortality. Chi-square test was used to compare the proportion of precipitating factors versus hospital stay and grade with significance at p < 0.05. Results: Of the 404 patients 252 (62%) were males. Hepatitis C virus was the cause of cirrhosis in 283 (70%); Child Turcotte Pugh (CTP) class C was present in 317 (78%) patients. On presentation, 17% patients had grade 1 HE while 44%, 29% and 10% had grades 2, 3 and 4 respectively. The most common precipitant of HE was spontaneous bacterial peritonitis in 83 (20.5%), constipation in 74 (18.3%) and urinary tract infection in 62 (15.3%). One hundred and forty (35%) patients had ≥ 2 precipitating factors while no precipitant was noted in 50 (12%) patients. Mean hospital stay was 4±3 days. The lesser the number of precipitants, shorter was the length of stay (p < 0.01) and lesser was the grade of HE (p=0.025). Complete reversal of HE was noted in 366 patients (91%) while the remaining had grade 1 HE on discharge. Nine (2.2%) patients died during the hospital stay. No mortality was noted in patients without precipitants. Conclusion: Patients presenting with ≥ 2 precipitating factors and advanced grade of HE had a prolonged hospital stay. Moreover, patients without precipitants had better outcomes.
Clinical Spectrum of Precipitating Factors of Hepatic Encephalopathy in Patient of Liver Cirrhosis
Objective: To determine the precipitating factors of hepaticencephalopathy (HE) in patients with liver cirrhosis Background and Objectives: Hepatic encephalopathy is an extra hepatic complication of impairedliver function and is manifested as neuropsychiatric signs and symptoms associated with acute or chronic liver disease in the absence of other neurological disorders. This study aims to ascertain the spectrum of precipitating factors of hepatic encephalopathy in patients with cirrhosis of liver.