Prospective Multicenter Observational Study of Overt Hepatic Encephalopathy

Digestive Diseases and Sciences
C S LandisB F Scharschmidt

Abstract

Overt hepatic encephalopathy (OHE) is a frequent complication of decompensated cirrhosis. A multicenter prospective observational study was performed to assess the most commonly recorded presenting manifestations of OHE and its associated health-care burden. Qualifying patients must have experienced ≥1 OHE episode within 30 days of enrollment (qualifying OHE) and were followed for recurrence (on-study OHE). Two hundred and sixty-five patients were enrolled at 30 sites and followed for up to 9 months (mean 72 days). Seventy-two patients experienced 122 on-study episodes; with 72, 23, and 13 having ≥1, ≥2, or ≥3 on-study episodes with median days to occurrence of the 1st, 2nd, and 3rd episode of 34, 19, and 11, respectively. The most frequently recorded OHE manifestations included confusion (78 %), change in mental status (57 %), disorientation (48 %), lethargy (46 %), and asterixis (45 %). West Haven grade was used inconsistently and recorded for only 28 % of episodes. Most qualifying and on-study episodes occurred on rifaximin (60 and 82 %, respectively) and were associated with hospitalization (68 and 85 %, respectively). Twenty-three patients experienced ≥2 on-study episodes within 2 months of enrollment on average (median 45...Continue Reading

References

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Citations

Aug 11, 2016·Liver International : Official Journal of the International Association for the Study of the Liver·Elliot B Tapper
Oct 11, 2016·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Jasmohan S BajajK Rajender Reddy
May 31, 2018·Liver International : Official Journal of the International Association for the Study of the Liver·Mary J ThomsonElliot B Tapper
Mar 21, 2019·Current Opinion in Gastroenterology·Jamil S Alsahhar, Robert S Rahimi
Jul 1, 2017·Journal of Clinical and Translational Hepatology·Saleh Elwir, Robert S Rahimi
Oct 5, 2018·Therapeutic Advances in Gastroenterology·Steven L FlammArun J Sanyal

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