Objective To investigate the risk factors for poor short-term prognosis of patients with hepatic encephalopathy (HE) .Methods A retrospective analysis was performed for the clinical data of 316 patients with HE who were hospitalized and treated in The First Hospital of Jilin University from January 2013 to December 2015, and according to their prognosis, they were divided into survival group (229patients) and death group (87 patients) .The univariate and multivariate analyses were performed for their general data and biochemical parameters to screen out the risk factors for poor prognosis of HE.The t-test or Mann-Whitney U test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups.The multivariate logistic regression analysis was performed for the variables with statistical significance identified in the univariate analysis.Results All the patients were followed up for 30 days, and 87 patients died, resulting in a mortality rate of 27.5%.The male/female ratio was 1.72∶ 1, and 269 patients (85.13%) were aged ≥45 years.The univariate analysis showed that there were significant differences between the two groups in age, a combination of primary liver cancer, HE stage, white blood cell count, neutrophil count, hemoglobin, platelet count, international normalized ratio, prothrombin time, prothrombin time activity (PTA) , blood urea nitrogen, creatinine, serum sodium, serum potassium, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, albumin, indirect bilirubin, total bilirubin (TBil) , and prealbumin (all P<0.05) .The multivariate analysis showed that a combination of primary liver cancer (OR=3.278, 95% CI: 1.494-7.194, P=0.003) , HE stage (OR=2.402, 95% CI: 1.711-3.372, P<0.001) , PTA (OR=0.969, 95% CI:0.951-0.988, P=0.001) , serum sodium (OR=0.956, 95% CI: 0.922-0.992, P=0.018) , and TBil (OR=1.004, 95% CI:1.003-1.006, P<0.001) were independent risk factors for the prognosis of patients with HE.Conclusion A combination of primary liver cancer, advanced HE stage, low serum sodium, low PTA, and increased TBil are independent risk factors for poor prognosis of HE, and the equation based on these indices has a certain reference value in clinical practice.
DownLoad: