Hepatic encephalopathy is an important component of hepatic decompensation, which reduces survival in patients with cirrhosis.
The Model for End-Stage Liver Disease (MELD) score has been used to predict survival of patients with cirrhosis.
Dr Charmaine Stewart and colleagues from Minnesota, USA determined whether hepatic encephalopathy is a predictor of survival of patients with cirrhosis.
The research team examined the degree to which hepatic encephalopathy may add to the survival prediction of MELD.
Patients with end-stage liver disease whose data were available in 2 databases were included in the analysis.
|Hepatic encephalopathy was also associated 4-fold increase in hospitalized patients|
The research team identified 223 patients undergoing transjugular intrahepatic portosystemic shunt insertion.
The team found a further 271 patients hospitalized with hepatic decompensation.
Using univariate analysis, hepatic encephalopathy grade 3 or higher was associated with a 4-fold increase in the risk of death in the transjugular intrahepatic portosystemic shunt patients.
The team found that hepatic encephalopathy grade 2 or higher was also associated 4-fold increase in hospitalized patients.
As expected, MELD and Child-Turcotte-Pugh scores were markedly associated with survival.
When hepatic encephalopathy and MELD were considered together, the team noted that hepatic encephalopathy remained strongly significant in the hospitalized patients.
The research team observed that the effect became smaller in the transjugular intrahepatic portosystemic shunt patients.
Dr Stewart's team concluded, "This retrospective study demonstrates that hepatic encephalopathy is an important event in the natural history of cirrhosis that affects subsequent survival of patients."
"Hepatic encephalopathy may provide additional prognostic information independent of MELD, which warrants prospective validation."