Natural history of covert hepatic encephalopathy: An observational study of 366 cirrhotic patients : = Natural history of covert hepatic encephalopathy: An observational study of 366 cirrhotic patients
AIM To explore the natural history of covert hepatic encephalopathy(CHE) in absence of medication intervention.METHODS Consecutive outpatient cirrhotic patients in a Chinese tertiary care hospital were enrolled and evaluated for CHE diagnosis. They were followed up for a mean of 11.2 ± 1.3 mo. Time to the first cirrhosis-related complications requiring hospitalization, including overt HE(OHE), resolution of CHE and death/transplantation, were compared between CHE and no-CHE patients. Predictors for complication(s) and death/transplantation were also analyzed.RESULTS A total of 366 patients(age: 47.2 ± 8.6 years, male: 73.0%) were enrolled. CHE was identified in 131 patients(35.8%). CHE patients had higher rates of death and incidence of complications requiring hospitalization, including OHE, compared to unimpaired patients. Moreover, 17.6% of CHE patients developed OHE, 42.0% suffered persistent CHE, and 19.8% of CHE spontaneously resolved. In CHE patients, serum albumin < 30 g/L(HR = 5.22, P = 0.03) was the sole predictor for developing OHE, and blood creatinine > 133 μmol/L(HR = 4.75, P = 0.036) predicted mortality. Child-Pugh B/C(HR = 0.084, P < 0.001) and OHE history(HR = 0.15, P = 0.014) were predictors of spontaneous resolution of CHE.CONCLUSION CHE exacerbates, persists or resolves without medication intervention in clinically stable cirrhosis. Triage of patients based on these predictors will allow for more cost-effect management of CHE..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017-09-14 2017 |
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| Erschienen: |
2017-09-14 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2017 |
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| Enthalten in: |
World journal of gastroenterology - (2017), 34 vom: 14. Sept., Seite 6321-6329 Original Letters: Enthalten in (DE-576)276271955 (DE-576)276271955 |
| Reihe: |
China Academic Journals (CAJ), E, 医药卫生科技 = Medicine & Public Health |
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| Sprache: |
Chinesisch |
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| Weiterer Titel: |
Natural history of covert hepatic encephalopathy: An observational study of 366 cirrhotic patients |
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| Beteiligte Personen: |
An-Jiang Wang [VerfasserIn] |
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| Links: |
oversea.cnki.net [lizenzpflichtig] |
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| Anmerkungen: |
Author info:An-Jiang Wang;A-Ping Peng;Bi-Min Li;Na Gan;Li Pei;Xue-Lian Zheng;Jun-Bo Hong;Hai-Ying Xiao;Jia-Wei Zhong;Xuan Zhu;Department of Gastroenterology and Hepatology,The First Affiliated Hospital of Nanchang University;Department of Radiology,The First Affiliated Hospital of Nanchang University;Department of Pharmacy,The First Affiliated Hospital of Nanchang University |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
CAJ570979560 |
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| 245 | 1 | 0 | |a Natural history of covert hepatic encephalopathy: An observational study of 366 cirrhotic patients |b = Natural history of covert hepatic encephalopathy: An observational study of 366 cirrhotic patients |
| 246 | 3 | 1 | |a Natural history of covert hepatic encephalopathy: An observational study of 366 cirrhotic patients |
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| 500 | |a Author info:An-Jiang Wang;A-Ping Peng;Bi-Min Li;Na Gan;Li Pei;Xue-Lian Zheng;Jun-Bo Hong;Hai-Ying Xiao;Jia-Wei Zhong;Xuan Zhu;Department of Gastroenterology and Hepatology,The First Affiliated Hospital of Nanchang University;Department of Radiology,The First Affiliated Hospital of Nanchang University;Department of Pharmacy,The First Affiliated Hospital of Nanchang University | ||
| 520 | |a AIM To explore the natural history of covert hepatic encephalopathy(CHE) in absence of medication intervention.METHODS Consecutive outpatient cirrhotic patients in a Chinese tertiary care hospital were enrolled and evaluated for CHE diagnosis. They were followed up for a mean of 11.2 ± 1.3 mo. Time to the first cirrhosis-related complications requiring hospitalization, including overt HE(OHE), resolution of CHE and death/transplantation, were compared between CHE and no-CHE patients. Predictors for complication(s) and death/transplantation were also analyzed.RESULTS A total of 366 patients(age: 47.2 ± 8.6 years, male: 73.0%) were enrolled. CHE was identified in 131 patients(35.8%). CHE patients had higher rates of death and incidence of complications requiring hospitalization, including OHE, compared to unimpaired patients. Moreover, 17.6% of CHE patients developed OHE, 42.0% suffered persistent CHE, and 19.8% of CHE spontaneously resolved. In CHE patients, serum albumin < 30 g/L(HR = 5.22, P = 0.03) was the sole predictor for developing OHE, and blood creatinine > 133 μmol/L(HR = 4.75, P = 0.036) predicted mortality. Child-Pugh B/C(HR = 0.084, P < 0.001) and OHE history(HR = 0.15, P = 0.014) were predictors of spontaneous resolution of CHE.CONCLUSION CHE exacerbates, persists or resolves without medication intervention in clinically stable cirrhosis. Triage of patients based on these predictors will allow for more cost-effect management of CHE. | ||
| 610 | 2 | 4 | |a Department of Gastroenterology and Hepatology,The First Affiliated Hospital of Nanchang University |
| 610 | 2 | 4 | |a Department of Radiology,The First Affiliated Hospital of Nanchang University |
| 610 | 2 | 4 | |a Department of Pharmacy,The First Affiliated Hospital of Nanchang University |
| 650 | 4 | |a 消化系及腹部疾病 | |
| 650 | 4 | |a 内科学 | |
| 650 | 4 | |a 医药、卫生 | |
| 650 | 4 | |a Digestive System Disease | |
| 650 | 4 | |a 医药卫生科技 | |
| 650 | 4 | |a Medicine & Public Health | |
| 650 | 4 | |a Covert hepatic encephalopathy | |
| 650 | 4 | |a Overt hepatic encephalopathy | |
| 650 | 4 | |a Natural history | |
| 650 | 4 | |a Liver cirrhosis | |
| 700 | 0 | |a A-Ping Peng |4 oth | |
| 700 | 0 | |a Bi-Min Li |4 oth | |
| 700 | 0 | |a Na Gan |4 oth | |
| 700 | 0 | |a Li Pei |4 oth | |
| 700 | 0 | |a Xue-Lian Zheng |4 oth | |
| 700 | 0 | |a Jun-Bo Hong |4 oth | |
| 700 | 0 | |a Hai-Ying Xiao |4 oth | |
| 700 | 0 | |a Jia-Wei Zhong |4 oth | |
| 700 | 0 | |a Xuan Zhu |4 oth | |
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