ArticleDigestive diseases and sciences2017
A New Look at Precipitants of Overt Hepatic Encephalopathy in Cirrhosis.
Article in Digestive diseases and sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Aminoglycosides, vancomycin, and metronidazole for people with cirrhosis and hepatic encephalopathy.The Cochrane database of systematic reviews · 2026Pooled it
- Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis.The Cochrane database of systematic reviews · 2023Pooled it
- Pharmacotherapies that specifically target ammonia for the prevention and treatment of hepatic encephalopathy in adults with cirrhosis.The Cochrane database of systematic reviews · 2019Pooled it
- Multiple Concomitant Precipitating Factors of Hepatic Encephalopathy Are Associated With a Poor Prognosis in Patients With Cirrhosis Admitted to Intensive Care Unit.United European gastroenterology journal · 2025Article
- Small Intestinal Bacterial Overgrowth Is a Predictor of Overt Hepatic Encephalopathy in Patients with Liver Cirrhosis.Journal of clinical medicine · 2025Article
- TIPS and hepatic encephalopathy in patients with cirrhosis.Metabolic brain disease · 2025Review
- Systems of care that improve outcomes for people with hepatic encephalopathy.Metabolic brain disease · 2024Review
- Rifaximin discontinuation during broad-spectrum antibiotic treatment in critically ill patients with hepatic encephalopathy.World journal of hepatology · 2024Article
- The crucial role of risk factors when dealing with hepatic Encephalopathy.Metabolic brain disease · 2024Review
- Medication burden and anticholinergic use are associated with overt HE in individuals with cirrhosis.Hepatology communications · 2024Article
- Rifaximin Use, Adherence and Persistence in Patients with Hepatic Encephalopathy: A Real-World Study in the South of Italy.Journal of clinical medicine · 2023Article
- Impact of Gastroenterology Consultation on the Clinical Outcomes of Patients Admitted With Hepatic Encephalopathy.Cureus · 2023Article
- Barriers to Lactulose Adherence in Patients with Cirrhosis and Hepatic Encephalopathy.Digestive diseases and sciences · 2023Article
- Old and New Precipitants in Hepatic Encephalopathy: A New Look at a Field in Continuous Evolution.Journal of clinical medicine · 2023Review
- Inadequate practices for hepatic encephalopathy management in the inpatient setting.Journal of hospital medicine · 2022Review
- Hepatic Encephalopathy-Related Hospitalizations in Cirrhosis: Transition of Care and Closing the Revolving Door.Digestive diseases and sciences · 2022Review
- Unexpected clinical outcomes following the implementation of a standardised order set for hepatic encephalopathy.BMJ open gastroenterology · 2021Article
- The Psychometric Hepatic Encephalopathy Syndrome score does not correlate with blood ammonia, endotoxins or markers of inflammation in patients with cirrhosis.Translational gastroenterology and hepatology · 2021Article
- A retrospective study of drug utilization and hospital readmissions among Medicare patients with hepatic encephalopathy.Medicine · 2020Observational
- Chronic Rifaximin Use in Cirrhotic Patients Is Associated with Decreased Rate of C. difficile Infection.Digestive diseases and sciences · 2020Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsOvert hepatic encephalopathy (HE) is a major cause of significant morbidity and mortality in patients with liver cirrhosis. We examined the frequency and profile of the precipitating factors resulting in hospitalizations for overt HE.
methodsWe conducted both retrospective and prospective studies to identify clinical precipitants of overt HE in patients with cirrhosis. The retrospective study patients were hospitalized at a large urban safety-net hospital, and the prospective study included the patients admitted at a liver transplant center.
resultsThere were a total of 149 patients with cirrhosis and overt HE (91 males, mean age 55.3 ± 8.6 years) in the retrospective group and 45 patients (27 males, mean age 58.3 ± 8.2 years) in the prospective group of the study. The average MELD score was 16 ± 6.8 in the retrospective group and 22.7 ± 7.2 in the prospective group. Dehydration (46-76%), acute kidney injury (32-76%), lactulose nonadherence (about 50%), constipation (about 40%), and infections (20-42%) were the most frequently identified precipitants for hospitalization in retrospective and prospective groups. Multiple precipitants were identified in 60 (40.3%) patients in the retrospective group and 34 (76%) patients in the prospective group.
conclusionsMultiple concurrent precipitating factors were identified in the majority of patients with overt HE requiring hospitalization. Dehydration due to various causes was the most common precipitant of overt HE, followed by acute kidney injury (AKI), constipation, and infections. Prevention of dehydration, AKI, and constipation by close outpatient monitoring may be an effective measure to prevent hospitalization for overt HE in patients with cirrhosis.
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