ArticleUnited European gastroenterology journal2021
The incidence and outcome of postoperative hepatic encephalopathy in patients with cirrhosis.
Article in United European gastroenterology journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Specific Items of Enhanced Recovery After Surgery for Liver Surgery in Cirrhotic Patients: A Systematic Review.World journal of surgery · 2025Pooled it
- Prognosis of Cirrhotic Patients After Osteoporotic Femoral Neck Fracture.Journal of clinical medicine · 2024Article
- The Management of Postoperative Cognitive Dysfunction in Cirrhotic Patients: An Overview of the Literature.Medicina (Kaunas, Lithuania) · 2023Review
- Guidelines, top-notch science & social media-Jump on the bandwagon.United European gastroenterology journal · 2022Article
- The incidence and outcome of postoperative hepatic encephalopathy in patients with cirrhosis.United European gastroenterology journal · 2021Article
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundCirrhosis is associated with increased perioperative risks related to hepatic decompensation. However, data are lacking regarding the incidence and outcomes of postoperative hepatic encephalopathy (HE).
objectiveTo determine the incidence of HE postoperatively, factors associated with its development, and its association with in-hospital mortality.
methodsRetrospective cohort study of 583 patients with cirrhosis undergoing non-hepatic surgery over a 10-year period. Outcomes included postoperative HE and in-hospital mortality and were, respectively, evaluated using multi-state modeling and Fine-Gray competing risk regression (with postoperative HE as a time-varying covariate).
resultsOverall, the median Model for End-Stage Liver Disease Sodium was 10, 61.7% had a history of ascites, 49.9% esophageal varices, and 34.6% HE. The most common surgeries including abdominal/non-bowel (33.3%), orthopedic (18.0%), and bowel (12.2%). A total of 42 (7.2%) patients developed HE postoperatively during admission. The cumulative risk of HE was 7.2%, which was most associated with a history of HE, ASA class, postoperative AKI, and postoperative infection. In-hospital mortality occurred in 34 (5.8%) individuals. Only ASA class was independently associated (HR 2.46, 95%CI 1.21-5.02), but there was a trend for postoperative HE (HR 1.71, 95%CI 0.73-3.98). DISCUSSION: HE is an uncommon but not rare postoperative complication that increases the risk of patient harm. This study implies its development is predictable. Consequently, at-risk patients should have consultation with a hepatologist before undergoing elective surgery.
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