Duration of the acute hepatic encephalopathy episode determines survival in cirrhotic patients
Ventura-Cots, Meritxell (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Carmona, Isabel
Moreno, Carolina
Ampuero, Javier
Simón-Talero, Macarena (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Sanpedro, Francesc (Hospital Universitari Vall d'Hebron)
Les, Iñigo
Romero-Gómez, Manuel
Genescà Ferrer, Joan (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Data:	2017
Resum:	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. 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. Median (IQR) 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). The duration of the acute HE episode determines survival in cirrhotic patients independently of liver function and baseline HE grade.
Ajuts:	Instituto de Salud Carlos III PI14/00331 Instituto de Salud Carlos III PI15/00066
Nota:	Altres ajuts: MST is a recipient of a Río Hortega grant from Instituto de Salud Carlos III, Spain. JG is a recipient of a Research Intensification grant from Instituto de Salud Carlos III, Spain. MVC is a recipient of a scholarship grant for study extension abroad, sponsored by the Spanish Association for the Study of the Liver. CIBERehd is supported by Instituto de Salud Carlos III, Spain.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Hepatic encephalopathy ; Time in hepatic encephalopathy ; Transplant-free survival
Publicat a:	Therapeutic Advances in Gastroenterology, Vol. 11 (november 2017) , ISSN 1756-2848

DOI: 10.1177/1756283X17743419
PMID: 29383024

12 p, 699.5 KB

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