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Precipitating factors of hepatic encephalopathy at a tertiary care hospital Jamshoro, Hyderabad.

OBJECTIVE
To determine the precipitating factors of hepatic encephalopathy (HE) in patients with liver cirrhosis at Liaquat University Hospital Hyderabad/Jamshoro.


METHODS
This hospital based descriptive study was conducted from April 2007 to September 2007. All the patients who were more than 12 years of age and were diagnosed as hepatic encephalopathy were studied. During this period, 87 patients of hepatic encephalopathy were admitted. All patients were carefully examined, relevant investigations were performed and data was collected through pre-designed proforma.


RESULTS
Male patients were 65 (75%), above 40 years of age 58 (67%), belonging to interior/periphery of Sindh 54 (62%), in grade IV of hepatic encephalopathy 70 (80%) and Anti-HCV positive were 52 (60%). The most common precipitating factors detected were infection 58 (67%), constipation 43 (49%) and gastrointestinal bleeding 39 (45%). Out of 87 patients, 68 had increased total leucocytes count, 09 patients had hypokalaemia, 24 patients, hyponatraemia, 64 hypoalbuminaemia and 54 patients had a disturbed coagulation profile. Fifty nine patients recovered and were discharged while 20 patients expired. Majority of expired patients had Child-Pugh score 10-15 and were in grade IV of hepatic encephalopathy.


CONCLUSION
The study concluded that there were different factors which play a key role in hepatic encephalopathy. In these factors, infection was the most common.