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Date Published: 01/07/2025
Abstract Views: 158
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DOI: https://doi.org/10.51298/vmj.v551i3.14767
Issue
Vol. 551 No. 3 (2025)
Section
Các bài báo
How to Cite
Tô Thị Diễm, P., Nguyễn Thanh, L., & Lê Văn, N. (2025). INVESTIGATION OF FACTORS ASSOCIATED WITH THE SEVERITY OF HEPATIC ENCEPHALOPATHY IN CIRRHOTIC PATIENTS AT CAN THO CENTRAL GENERAL HOSPITAL. Vietnam Medical Journal, 551(3). https://doi.org/10.51298/vmj.v551i3.14767

INVESTIGATION OF FACTORS ASSOCIATED WITH THE SEVERITY OF HEPATIC ENCEPHALOPATHY IN CIRRHOTIC PATIENTS AT CAN THO CENTRAL GENERAL HOSPITAL

Phương Tô Thị Diễm, Liêm Nguyễn Thanh, Nho Lê Văn

Main Article Content

Abstract

Background: Hepatic encephalopathy (HE) is a common complication in cirrhotic patients, signaling a poor prognosis and increasing mortality rates. Identifying factors associated with HE severity is essential for early prevention and management, thereby improving patient outcomes. Objectives: To investigate several factors associated with the severity of hepatic encephalopathy in patients with liver cirrhosis. Materials and methods: A cross-sectional descriptive study with analytical components was conducted on 82 cirrhotic patients treated at Can Tho Central General Hospital from January 2024 to January 2025. Results: Regarding general characteristics, the male-to-female ratio was approximately 1.65, with a mean age of 61.91 ± 14.08 years; the majority (56.1%) were over 60 years old. The most common etiologies of cirrhosis were hepatitis B virus infection (32.9%) and alcohol-related liver disease (22.0%). Most patients were classified as Child-Pugh C (61.0%). Grade II HE accounted for 50.0%, a proportion equivalent to the combined total of grade III and IV HE, with grade III HE making up 36.6%. Assessment of factors related to HE severity showed that gastrointestinal bleeding was significantly associated with an increased likelihood of grade III–IV HE, with an odds ratio (OR) of 2.8 (95% CI: 1.1–7.3), p = 0.034. Furthermore, the neutrophil-to-lymphocyte ratio (NLR) was significantly higher in patients with grade III and IV HE compared to those with grade II HE (p < 0.05). No association was found between serum ammonia levels and HE severity. Conclusion: Gastrointestinal bleeding and elevated NLR are associated with increased severity of hepatic encephalopathy. 

Article Details

Keywords

Hepatic encephalopathy (HE), cirrhosis, associated factors

References

1. Elwir S, Rahimi RS (2017), "Hepatic Encephalopathy: An Update on the Pathophysiology and Therapeutic Options", J Clin Transl Hepatol, 5(2), pp. 142-151.
2. Vilstrup H, Amodio P, Bajaj J, et al. (2014), "Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver", Hepatology, 60(2), pp. 715-35.
3. Tapper EB, Henderson JB, Parikh ND, et al. (2019), "Incidence of and Risk Factors for Hepatic Encephalopathy in a Population-Based Cohort of Americans With Cirrhosis", Hepatol Commun, 3(11), pp. 1510-1519.
4. European Association for the Study of the Liver (2022), "EASL Clinical Practice Guidelines on the management of hepatic encephalopathy", J Hepatol, 77(3), pp. 807-824.
5. Elias TP, Shewaye AB, Fisseha H, et al. (2025), "Predictors of in-hospital mortality among cirrhotic patients in Ethiopia: A multicenter retrospective study", PLoS One, 20(4), pp. e0322532.
6. Bleibel W, Al-Osaimi AM (2012), "Hepatic encephalopathy", Saudi J Gastroenterol, 18(5), pp. 301-9.
7. Demirciler E, Danis N, Ergun P, et al. (2023), "Psychometric tests, critical flicker frequency, and inflammatory indicators in covert hepatic encephalopathy diagnosis", Hepatol Forum, 4(1), pp. 19-24.
8. Sharma P, Sharma BC (2010), "Predictors of minimal hepatic encephalopathy in patients with cirrhosis", Saudi J Gastroenterol, 16(3), pp. 181-7.