EPIDEMIOLOGY AND CLINICAL PROFILE OF HEPATIC ENCEPHALOPATHY IN TERTIARY CARE HOSPITAL, GGH, KAKINADA
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 24
Abstract
BACKGROUND Hepatic Encephalopathy (HE) is defined as a spectrum of neuropsychiatric abnormalities in patient with liver dysfunction, after exclusion of other known brain diseases. It is a potentially reversible condition. Its spectrum ranges from minimal hepatic encephalopathy without recognisable clinical symptoms or signs to overt hepatic encephalopathy with risk of cerebral oedema and death. The burden of disease for cirrhosis is increasing, especially with regard to the rise in the number of patients with hepatitis C and E or non-alcoholic steatohepatitis. MATERIALS AND METHODS Patients with hepatic encephalopathy admitted in Department of Medicine, Government General Hospital, Kakinada were studied during the period of December 2013 - November 2016. Before commencement of study, permission was obtained from Ethics Committee, Rangaraya Medical College, Kakinada. All enrolled patients were informed about the nature of the study and their right to refuse. The informed written consent was taken before including them in the study. Sample Size was 100 patients. This study design was observational study and patients who fulfil the inclusion criteria. RESULTS In this study, the commonest cause of hepatic encephalopathy was found to be due to alcoholism (43%), all of them were males. HBV infection was the second commonest cause with 33%, of which 65% were females. In 12% of patients, the cause was HCV infection. Cause was not known in 8% cases of hepatic encephalopathy, which were thought to be NASH/NAFLD. In 4% of patients, both HBV and alcoholism were aetiological factors. Female preponderance was seen in non-alcohol groups, especially in cryptogenic cirrhosis. CONCLUSION Out of 100 patients, 51% recovered and were discharged, 49% of patients expired of which 62% were males and 38% were females. Mortality rate among patients with hepatic encephalopathy in males and females in the present study were 47% and 51% respectively. Females have relatively poor prognosis than male. Higher fatality rate were recorded with increasing severity of encephalopathy. According to West Haven classification out of the 36 patients, 34 expired in Grade IV. Out of the 31 patients, there was no mortality in Grade I hepatic encephalopathy. In Grade IV hepatic encephalopathy, the mortality was more than 80%. The number of patients who expired according to Child-Pugh score were 85% in Class C, 15% in Class B and none in Class A. Mortality of patients in Class C was 70%.
Authors and Affiliations
NVA Benhar, Vijaya Kumar H
Keywords
Related Articles
- EP ID EP215327
- DOI 10.18410/jebmh/2017/270
- Views 113
- Downloads 0
INFLUENCE OF AMNIOTIC FLUID INDEX ON FOETAL OUTCOME
BACKGROUND AND OBJECTIVE: In these days of smaller families and the obstetrician having to share the onus of giving a healthy child capable of independent existence as well as to ensure that the population is limited for...
RIVES AND LICHTENSTEIN REPAIR IN INGUINAL HERNIA- A COMPARISON OF POSTOPERATIVE COMPLICATIONS TO KNOW WHETHER RIVES REPAIR IS AS SAFE AS THE GOLD STANDARD LICHTENSTEIN REPAIR
BACKGROUND Hernia repair surgeries underwent a lot of modifications over time. These modifications were an attempt to reduce the recurrence rate and post-operative complications. Current techniques for Inguinal hernia sh...
PAEDIATRIC OVARIAN TORSION- SALVAGING THE UNSALVAGEABLE
BACKGROUND Ovariectomy used to be the conventional treatment for ovarian torsion in the paediatric age group. A paradigm shift in the management of paediatric ovarian torsion was reported in recent years, with ovarian re...
MEDICAL TERMINATION OF PREGNANCY: SIX YEARS STUDY OF THE TREND AND PROFILE OF THE CLIENTS IN A METROPOLITAN PUBLIC HOSPITAL
BACKGROUND To increase the incidence of safe and legalised abortions, it is important to know the clients. This study is a 6 years research of the records of MTP performed at the public hospital attached to a medical col...
EPIDEMIOLOGY OF COMMON OCULAR DISEASES IN DIABETES MELLITUS IN A TEACHING HOSPITAL
BACKGROUND Diabetes mellitus has exponentially increased from 108 million in 1980 to 422 million in year 2014 with the prevalence rate nearly doubling from 4.7% to 8.5%. Since it affects the economically productive age g...