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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 2
Feb.  2022
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Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(2): 359-364

Covert hepatic encephalopathy in liver cirrhosis: Risk factors and prognosis

DOI: 10.3969/j.issn.1001-5256.2022.02.020
  • a.

    Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China

  • b.

    Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China

  • c.

    Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China

Research funding:

2019 Chongqing Technology Innovation and Application Development Project (cstc2019jscx-msxmX0117)

More Information
  • Corresponding author: WANG Xiaomei, 300394@hospital.cqmu.edu.cn
  • Received Date: 2021-06-22
  • Accepted Date: 2021-08-12
  • Published Date: 2022-02-20
    Abstract
  •   Objective  To investigate the risk factors for covert hepatic encephalopathy (CHE) in patients with liver cirrhosis and their influence on prognosis.  Methods  A total of 416 patients with liver cirrhosis who were hospitalized in a grade A tertiary hospital in Chongqing from September 2019 to June 2020 were enrolled in the study, and according to the presence or absence of CHE, they were divided into CHE group with 212 patients and non-CHE group with 204 patients. Clinical data and laboratory examination results were collected, and follow-up was performed for 6 months. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test, the continuous correction chi-square test, and the Mann-Whitney U test were used for comparison of categorical data between groups. Univariate and multivariate logistic regression analyses were used to analyze the risk factors for CHE.  Results  The incidence rate of CHE was 51%. The univariate analysis showed that age, course of disease, the medical history of hepatic encephalopathy (HE), infection, ascites, electrolyte disturbance, hepatorenal syndrome, Child-Pugh class, prothrombin time, total bilirubin, creatinine, platelet, prothrombin activity, albumin, and Model for End-stage Liver Disease (MELD) score were the influencing factors for CHE (all P < 0.05). The multivariate logistic regression analysis showed that the medical history of HE (OR=10.848, 95% CI: 4.971-23.674, P < 0.05), transjugular intrahepatic portosystemic shunt (TIPS) (OR=4.334, 95%CI: 1.203-15.621, P < 0.05), Child-Pugh class (OR=4.968, 95%CI: 1.299-18.992, P < 0.05), and MELD score (OR=1.253, 95%CI: 1.161-1.352, P < 0.05) were independent predictive factors for CHE (P < 0.05). The follow-up study showed that CHE had an effect on the short-or medium-term readmission, HE, and death of patients (all P < 0.05).  Conclusion  CHE has a relatively high incidence rate and greatly affects the prognosis of patients with liver cirrhosis. The development of CHE should be taken seriously in patients with a past history of HE, a history of TIPS, Child-Pugh class C liver function, and a high MELD score, and identification, screening, and intervention should be performed as early as possible to improve the prognosis of patients with liver cirrhosis.

     

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