ArticlePloS one2018
Multiple bacterial infections increase the risk of hepatic encephalopathy in patients with cirrhosis.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 22 citations in OpenAlex.
- A columnar graphical prediction model for hepatic encephalopathy secondary to decompensated cirrhosis in hepatitis B cirrhosis.BMC infectious diseases · 2025Article
- Management of sepsis in a cirrhotic patient admitted to the intensive care unit: A systematic literature review.World journal of hepatology · 2023Article
- Hepatic encephalopathy.Nature reviews. Disease primers · 2022Review
- Hepatic Encephalopathy-Related Hospitalizations in Cirrhosis: Transition of Care and Closing the Revolving Door.Digestive diseases and sciences · 2022Review
- Overt hepatic encephalopathy is an independent risk factor for de novo infection in cirrhotic patients with acute decompensation.Alimentary pharmacology & therapeutics · 2022Article
- Treatment outcomes in patients with pyogenic vertebral osteomyelitis who have cirrhosis.Scientific reports · 2019Article
- Clinical Consequences of Infection in Cirrhosis: Organ Failures and Acute-on-Chronic Liver Failure.Clinical liver disease · 2019Review
- Hepatic encephalopathy: Lessons from preclinical studies.World journal of hepatology · 2019Review
- Hepatic Encephalopathy in Cirrhotic Patients With Bacterial Infections: Frequency, Clinical Characteristics, and Prognostic Relevance.Journal of clinical and experimental hepatologyArticle
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Authors and funding
14 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePatients with liver cirrhosis (LC) are at increased risk for bacterial infections. It is not fully understood how exposure to infections induces further development of hepatic encephalopathy (HE). This study estimated risks of infection associated with HE among patients with LC.
methodsA nested case-control study of 14,428 adult patients with LC was performed using the population-based Longitudinal Health Insurance Database 2000 in Taiwan. Cases were cirrhotic patients who developed HE during follow-up. Controls were matched to each case by age at LC diagnosis (±2 years), sex, Charlson Comorbid index score, year of LC, and follow-up time with a 1:1 ratio. A multivariate logistic regression model was used to determine and compare the odds of developing HE based on exposure to various risk factors, including site of infection, cirrhosis-related complications, Helicobacter pylori eradication therapy, and peptic ulcer bleeding. Patient survival was evaluated using the time-dependent Cox regression model.
resultsCirrhotic patients with HE (n = 714) and without HE (n = 714) were matched to compare risks. Infections and more frequent yearly infections were significantly associated with increased risk of HE. Independent predictors of HE included spontaneous bacterial peritonitis (aOR, 5.13; 95% CI, 3.03-8.69), sepsis (aOR, 2.54; 95% CI, 1.82--3.53), and biliary tract infection (aOR, 2.03; 95% CI, 1.2-3.46), controlling for confounders.
conclusionFrequent infections are associated with increased risk of HE in cirrhotic patients. More frequent exposure to infection increases the risk of HE and mortality rates. Appropriate prevention of infection and the use of antibiotics for cirrhotic patients at risk for HE are needed.
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