Analysis Of Prognostic Factors Of Hepatic Encephalopathy

Objectives: The aim of this study was to investigate the prognostic factors of hepatic encephalopathy (HE) and provide bases for the treatment and prognosis judgment of HE.Methods: 169 patients who developed HE hospitalized in the two affiliated hospitals of Jinan University between July 1993 and June 2005 were included in the study. Medical records of these patients were retrospectively reviewed. The follow-up period was from the first episode of HE to the death of the patients. In patients whose death could not be confirmed, the follow-up was ended on their last visits, or the date of liver transplantation, or September 30, 2005. 32 variables were selected from clinical and biochemical examinations at the first episode of hepatic encephalopathy. The prognostic factors of HE were extracted from the 32 variables by Cox regression analysis and a prognostic index (PI) model for HE was established.Results: For the 169 patients with liver cirrhosis complicated by HE, the median survival time was 4.40 months, and the cumulative survival rate was 24.32% after 1 year, 18.83% after 2 years, and 9.98% after 5 years. Using Cox regression analysis, five factors, i.e., serum sodium, blood urea nitrogen (BUN), total serum cholesterol (Tchol), white blood cell count (WBC), and the Child-Pugh classification, were selected eventually as independent factors that significantly correlated with the outcome of HE. The PI value was calculated by the following formula consisting of these five factors. PI= 1.218 - 0.027 × serum sodium + 0.039 × BUN - 0.219 × Tchol + 0.046 × WBC + 1.216 × Child-Pugh classification. The 169 patients were divided equally into low-PI, median-PI, and high-PI groups according to their PI values which...