SPECTRUM OF PRECIPITATING FACTORS OF HEPATIC ENCEPHALOPATHY IN PATIENTS WITH LIVER CIRRHOSI

  • Ana Maria SÎNGEAP “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • T. CUCIUREANU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • S. ZENOVIA “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Irina GÎRLEANU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Laura HUIBAN “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Cristina Maria MUZICA “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • C. STANCIU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Anca TRIFAN “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Abstract

Hepatic encephalopathy (HE) is one of the most frequent and debilitating complications of liver cirrhosis. Identification and correction of precipitation factors are mandatory to ensure a favorable outcome. Material and methods: We performed a retrospective descriptive study in cirrhotic patients with HE hospitalized during one pandemic year in a tertiary care referral center. Demographic, clinical and biological parameters, as well as the etiology of the liver cirrhosis were recorded. Precipitating factors were identified, and their prevalence was calculated, overall and according to the two main etiologies of cirrhosis. Results: Prevalence of HE was 71%. The most frequent overall precipitating factors were infections (43.7%), gastrointestinal bleeding (31.6%), renal failure (28.9%) and dyselectrolytemia (26.2%). According to cirrhosis etiology, significant higher frequencies of sepsis and non-adherence to therapy were found in patients with alcoholic cirrhosis compared to those with virus-related cirrhosis (6.1% vs. 0.8%, p=0.012, and 15.5% vs. 8.3%, p=0.026, respectively), while prevalence of hepatocellular carcinoma as causal factor of HE was significantly higher in virus-related cirrhotic patients compared to alcoholic cirrhosis (14.3% and 6.4%, respectively, p=0.004). Non-variceal bleeding was recorded especially in alcoholic patients. About half of patients had one single precipitating factor, nearly 40% had multiple factors, while for 11% no factor was identified. Conclusions: HE has high prevalence in hospitalized cirrhotic patients. The most common precipitating factors are infections, gastrointestinal bleeding, renal disfunction and electrolyte imbalances. Particular risk factors were found in relation to the etiology of cirrhosis, data that could help apply a tailored, individually-adapted preventive strategy.

Author Biographies

Ana Maria SÎNGEAP, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
Institute of Gastroenterology and Hepatology

T. CUCIUREANU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
Institute of Gastroenterology and Hepatology

S. ZENOVIA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
Institute of Gastroenterology and Hepatology

Irina GÎRLEANU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
Institute of Gastroenterology and Hepatology

Laura HUIBAN, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
Institute of Gastroenterology and Hepatology

Cristina Maria MUZICA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
Institute of Gastroenterology and Hepatology

C. STANCIU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
Institute of Gastroenterology and Hepatology

Anca TRIFAN, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
Institute of Gastroenterology and Hepatology

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Published
2021-12-30
Section
INTERNAL MEDICINE - PEDIATRICS