Adherence to Recommended Inpatient Hepatic Encephalopathy Workup

Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine
Dennis KumralMohammad S Siddiqui

Abstract

Hepatic encephalopathy (HE) is characterized by altered sensorium and is the most common indication for hospitalization among patients with cirrhosis. Liver societal guidelines for inpatient HE revolve around identification of potential precipitants. In this retrospective study, we aimed to determine adherence to societal guidelines for evaluation of HE in 78 inpatients. The adherence rate to societal recommended guidelines for workup of HE was low, with only 17 (22%) patients having complete diagnostic workup within 24 hours of admission. Notably, 23 (30%) patients were not subjected to blood culture analysis, 16 (21%) were missing urinalysis, and 15 (20%) were missing chest radiograph. In patients with ascites (N = 34), 26 (77%) did not have a diagnostic paracentes is to exclude spontaneous bacterial peritonitis. In contrast, serum ammonia determination, a laboratory test not endorsed by societal guidelines for workup of HE, was ordered in 74 (95%) patients. These findings underscore the limited adherence to societal guidelines in hospitalized patients with HE.

Citations

May 28, 2019·Alimentary Pharmacology & Therapeutics·Patricia Pringle Bloom, Raymond T Chung
Nov 13, 2019·The American Journal of Gastroenterology·Elliot B Tapper, Robert S Rahimi
Apr 1, 2020·The American Journal of Gastroenterology·Jasmohan S BajajSara Montagnese
Jul 4, 2020·Clinical Liver Disease·Avash Kalra, J P Norvell
Jan 17, 2021·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Juan J Gonzalez, Elliot B Tapper
Nov 7, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Elliot B Tapper
Apr 23, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Elliot B Tapper, Neehar D Parikh
Dec 1, 2020·GE Portuguese Journal of Gastroenterology·Mariana Verdelho Machado

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