International normalized ratio and Model for End-stage Liver Disease score predict short-term outcome in cirrhotic patients after the resolution of hepatic encephalopathy

Hu, Xiaopeng; Gao, Jian

doi:10.3748/wjg.v25.i26.3426

Cited by 7 publications

(7 citation statements)

References 21 publications

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“…Similarly, HE is also an important feature of liver failure. Once HE occurs in patients with chronic liver disease, the prognosis is very poor, with a 1-year survival rate of less than 50% and a 3-year survival rate of less than 25%[ 46 ]. Studies have shown that INR is associated with the death of patients with cirrhosis[ 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

“…Once HE occurs in patients with chronic liver disease, the prognosis is very poor, with a 1-year survival rate of less than 50% and a 3-year survival rate of less than 25%[ 46 ]. Studies have shown that INR is associated with the death of patients with cirrhosis[ 46 , 47 ]. Moreover, a serum sodium imbalance is very common in cirrhotic patients with AKI and affect the prognosis of these patients[ 48 - 50 ].…”

Section: Discussionmentioning

confidence: 99%

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Development and validation of a nomogram for predicting overall survival in cirrhotic patients with acute kidney injury

Wan¹,

Wang²,

Zhang³

et al. 2022

WJG

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BACKGROUND Acute kidney injury (AKI) is a common and severe complication in patients with cirrhosis, and is associated with poor prognosis. Therefore, identifying cirrhotic patients with AKI who are at high risk of mortality is very important and may be helpful for providing timely medical interventions to improve the prognosis of these patients. However, studies focused on investigating the risk factors for the mortality of cirrhotic patients with AKI were scarce. AIM To identify risk factors for mortality and establish a nomogram for predicting the prognosis of these patients. METHODS Two hundred fifty consecutive patients with cirrhosis and AKI were recruited and randomly divided into training cohort ( n = 173) and validation cohort ( n = 77). In the training cohort, potential risk factors for death were identified by performing a Cox regression analysis, and a nomogram was established. The predictive performance of the nomogram was internally and externally validated by calculating the area under the receiver operating characteristic curve (AUROC), constructing a calibration curve and performing decision curve analysis. RESULTS The serum sodium level, international normalized ratio, peak serum creatinine level > 1.5 mg/dL, the presence of hepatic encephalopathy and diabetes were potential risk factors for mortality of cirrhotic patients with AKI in the training dataset. A prognostic nomogram incorporating these variables was established for predicting the overall survival of these patients. Compared with Child-Turcotte-Pugh, the model for end-stage liver disease (MELD) and the MELD-Na scores, the nomogram in predicting 90- and 180-d mortality exhibited better discriminatory power with AUROCs of 0.792 and 0.801 for the training dataset and 0.817 and 0.862 for the validation dataset, respectively. With a nomogram score of 98, patients were divided into low- and high-risk groups, and high-risk patients had a higher mortality rate. CONCLUSION A prognostic nomogram displayed good performance for predicting the overall survival of cirrhotic patients with AKI, and will assist clinicians in evaluating the prognosis of these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram for predicting overall survival in cirrhotic patients with acute kidney injury

Wan¹,

Wang²,

Zhang³

et al. 2022

WJG

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“…Similarly, in the study conducted by Koch et al, the INR level was found to be longer than normal in cases with HE resulting in death (16). In a study conducted in China, it was found that the high INR value at discharge after HE predicts readmission to the hospital and this may be associated with mortality (17). When the prolongation of aPTT, PT and INR levels among hemostasis parameters is considered in terms of mortality in patients with HE, it emerges as an important parameter.…”

Section: Discussionmentioning

confidence: 83%

Retrospective Evaluation of the Effect of Ammonia Levels on Mortality in Patients With Hepatic Encephalopathy Applying to the Emergency Department

GÜNGÖR

Erdem²

2021

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

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Objective: Hepatic encephalopathy is a cognitive, motor and behavioral disorder caused by the accumulation of liver metabolism products accompanying hepatic failure. The clinical picture of hepatic encephalopathy appears with the accumulation of metabolites such as ammonia and gamma aminobutyric acid. In our study, we aimed to investigate the effect of blood ammonia levels on mortality in patients diagnosed with hepatic encephalopathy. Material and Methods: The records of patients who were admitted to the emergency department of our hospital with impaired consciousness, known chronic liver disease, and whose ammonia levels were studied between January 01 2015 and December 31 2018 were retrospectively analyzed. Liver function tests and coagulation tests of the patients were recorded. The patients were divided into two groups as with and without hepatic encephalopathy. The groups were divided into stages according to the West Haven classification. Liver function tests and coagulation tests of the two groups were compared according to ammonia level, disease stage and mortality.

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“… 14 Hu et al noted in their study that INR at discharge (>1.62) independently predicted overall readmission after index PSE, and that the MELD score was the only variable that predicted readmission specifically because of PSE. 15 INR has been associated with a longer hospital stay in PSE patients. However, it did not significantly differ in our particular study.…”

Section: Discussionmentioning

confidence: 97%

Recurrence of portosystemic encephalopathy in cirrhotic patients and its risk factors

Karim,

Bin Khalid,

Essani

et al. 2023

Pak J Med Sci

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Objectives: Recurrent episodes of Portal Systemic Encephalopathy (PSE), poses a significant burden of illness on the patients and healthcare system. The objective of this study was to assess the recurrence of PSE in cirrhotic patients after index episode of PSE and to identify various risk factors associated with it. Methods: A retrospective, single-centre study was conducted at Aga Khan University Hospital over a span of one year. Patients who were admitted first time with PSE and admitted within three months of index PSE were enrolled in the study. Variables assessed were demographic data, associated comorbid conditions, aetiology of cirrhosis, Child-Turcotte-Pugh (CTP) score, Model of End-Stage Liver Disease (MELD) score, PSE grade, laboratory tests, ascites with spontaneous bacterial peritonitis (SBP), variceal bleeding. Statistical analysis was done and variables of those who developed recurrence were compared with those who did not. Results: Fifty one patients were recruited. Thirty three (64.7%) were readmitted with PSE. On comparative analysis of both groups; infection, Meld score, low albumin, and raised total bilirubin showed significant P-value (<0.05). Conclusion: Identification of risk factors during assessment can reduce the recurrence of PSE. We would recommend to validate result of our study on a large scale prospectively. doi: https://doi.org/10.12669/pjms.40.1.8025 How to cite this: Karim MM, Khalid AB, Sohail Z, Yasrab M. Recurrence of portosystemic encephalopathy in cirrhotic patients and its risk factors. Pak J Med Sci. 2024;40(1):---------. doi: https://doi.org/10.12669/pjms.40.1.8025 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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International normalized ratio and Model for End-stage Liver Disease score predict short-term outcome in cirrhotic patients after the resolution of hepatic encephalopathy

Cited by 7 publications

References 21 publications

Development and validation of a nomogram for predicting overall survival in cirrhotic patients with acute kidney injury

Development and validation of a nomogram for predicting overall survival in cirrhotic patients with acute kidney injury

Retrospective Evaluation of the Effect of Ammonia Levels on Mortality in Patients With Hepatic Encephalopathy Applying to the Emergency Department

Recurrence of portosystemic encephalopathy in cirrhotic patients and its risk factors

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