Hepatic encephalopathy increases the risk for mortality and hospital readmission in decompensated cirrhotic patients: a prospective multicenter study

Oliviero Riggio; Ciro Celsa; Vincenza Calvaruso; Manuela Merli; Paolo Caraceni; Sara Montagnese; Vincenzina Mora; Martina Milana; Giorgio Maria Saracco; Giovanni Raimondo; Antonio Benedetti; Patrizia Burra; Rodolfo Sacco; Marcello Persico; Filippo Schepis; Erica Villa; Antonio Colecchia; Stefano Fagiuoli; Mario Pirisi; Michele Barone; Francesco Azzaroli; Giorgio Soardo; Maurizio Russello; Filomena Morisco; Sara Labanca; Anna Ludovica Fracanzani; Antonello Pietrangelo; Gabriele Di Maria; Silvia Nardelli; Lorenzo Ridola; Antonio Gasbarrini; Calogero Cammà

doi:10.3389/fmed.2023.1184860

Back

Hepatic encephalopathy increases the risk for mortality and hospital readmission in decompensated cirrhotic patients: a prospective multicenter study

Journal article

Peer reviewed

Hepatic encephalopathy increases the risk for mortality and hospital readmission in decompensated cirrhotic patients: a prospective multicenter study

Oliviero Riggio, Oliviero Riggio, Ciro Celsa, Ciro Celsa, Vincenza Calvaruso, Manuela Merli, Paolo Caraceni, Paolo Caraceni, Sara Montagnese, Vincenzina Mora, …

Frontiers in medicine, Vol.10

01/05/2023

DOI: https://doi.org/10.3389/fmed.2023.1184860

Abstract

decompensated cirrhosis

hepatic encephalopathy

hospital readmission

mortality

orthotopic liver transplant

IntroductionHepatic encephalopathy (HE) affects the survival and quality of life of patients with cirrhosis. However, longitudinal data on the clinical course after hospitalization for HE are lacking. The aim was to estimate mortality and risk for hospital readmission of cirrhotic patients hospitalized for HE.MethodsWe prospectively enrolled 112 consecutive cirrhotic patients hospitalized for HE (HE group) at 25 Italian referral centers. A cohort of 256 patients hospitalized for decompensated cirrhosis without HE served as controls (no HE group). After hospitalization for HE, patients were followed-up for 12 months until death or liver transplant (LT).ResultsDuring follow-up, 34 patients (30.4%) died and 15 patients (13.4%) underwent LT in the HE group, while 60 patients (23.4%) died and 50 patients (19.5%) underwent LT in the no HE group. In the whole cohort, age (HR 1.03, 95% CI 1.01–1.06), HE (HR 1.67, 95% CI 1.08–2.56), ascites (HR 2.56, 95% CI 1.55–4.23), and sodium levels (HR 0.94, 95% CI 0.90–0.99) were significant risk factors for mortality. In the HE group, ascites (HR 5.07, 95% CI 1.39–18.49) and BMI (HR 0.86, 95% CI 0.75–0.98) were risk factors for mortality, and HE recurrence was the first cause of hospital readmission.ConclusionIn patients hospitalized for decompensated cirrhosis, HE is an independent risk factor for mortality and the most common cause of hospital readmission compared with other decompensation events. Patients hospitalized for HE should be evaluated as candidates for LT.

Metrics

8 Record Views

1 Times Cited - Web of Science

Details

Title: Hepatic encephalopathy increases the risk for mortality and hospital readmission in decompensated cirrhotic patients: a prospective multicenter study
Creators: Oliviero Riggio - Sapienza University of Rome
Oliviero Riggio - Department of Gastroenterology, “Santa Maria Goretti” Hospital, “Sapienza” Polo Pontino, Latina, Italy
Ciro Celsa - Section of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy
Ciro Celsa - Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Palermo, Italy
Vincenza Calvaruso - Section of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy
Manuela Merli - Sapienza University of Rome
Paolo Caraceni - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy
Paolo Caraceni - University of Bologna
Sara Montagnese - Department of Medicine, University of Padova, Padua, Italy
Vincenzina Mora - Medicina
Martina Milana - Hepatology and Liver Transplant Unit, University of Tor Vergata, Rome, Italy
Giorgio Maria Saracco - University of Turin
Giovanni Raimondo - 1Division of Medicine and Hepatology, University Hospital of Messina, Messina, Italy
Antonio Benedetti - 2Department of Gastroenterology and Hepatology, Università Politecnica delle Marche, Ancona, Italy
Patrizia Burra - 3Gastroenterology/Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
Rodolfo Sacco - University of Foggia
Marcello Persico - University of Salerno
Filippo Schepis - University of Modena and Reggio Emilia
Erica Villa - University of Modena and Reggio Emilia
Antonio Colecchia - University of Modena and Reggio Emilia
Antonio Colecchia - 7Unit of Gastroenterology, Borgo Trento University Hospital, Verona, Italy
Stefano Fagiuoli - University of Milan
Stefano Fagiuoli - 9Gastroenterology, Hepatology and Transplantation Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
Mario Pirisi - 0Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, Italy
Mario Pirisi - 1Internal Medicine Unit, Azienda Ospedaliera Universitaria (AOU) Maggiore della Carità Hospital, Novara, Italy
Michele Barone - 2Section of Gastroenterology, Department of Emergency and Organ Transplantation, University “Aldo Moro” of Bari, Bari, Italy
Francesco Azzaroli - University of Bologna
Giorgio Soardo - University of Udine
Giorgio Soardo - 5Italian Liver Foundation, Area Science Park, Trieste, Italy
Maurizio Russello - Azienda di Rilievo Nazionale ed Alta Specializzazione
Filomena Morisco - 7Gastroenterology and Hepatology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
Sara Labanca - University of Genoa
Anna Ludovica Fracanzani - 9Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
Anna Ludovica Fracanzani - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
Antonello Pietrangelo - 1Department of Internal and Emergency Medicine, University Hospital of Modena, Modena, Italy
Gabriele Di Maria - Section of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy
Silvia Nardelli - Sapienza University of Rome
Lorenzo Ridola - Sapienza University of Rome
Antonio Gasbarrini - Medicina
Calogero Cammà - Section of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy
Publication Details: Frontiers in medicine, Vol.10
Publisher: Frontiers Media S.A
Date published: 01/05/2023
Identifiers: 99771866602346
Academic Unit: School of Biosciences; Institute for Sustainability
Language: English
Resource Type: Journal article

Hepatic encephalopathy increases the risk for mortality and hospital readmission in decompensated cirrhotic patients: a prospective multicenter study

Abstract

Metrics

Details

Usage Policy