Liver-Unrelated Comorbid Conditions Do Not Affect Cognitive Performance or Hepatic Encephalopathy Progression in Cirrhosis

Am J Gastroenterol. 2021 Dec 1;116(12):2385-2389. doi: 10.14309/ajg.0000000000001346.

Abstract

Introduction: We aimed to determine the effect of comorbidities on covert hepatic encephalopathy (CHE) diagnosis and overt hepatic encephalopathy (OHE) development.

Methods: Cirrhotic outpatients underwent CHE testing and 2-year follow-up. Cox regression was performed for time to OHE. In total, 700 patients (60 years, 84% men, model for end-stage liver disease 11) and 33% prior OHE underwent testing and follow-up.

Results: Major comorbidities were hypertension (54%), diabetes (35%), and depression (29%). Common medications were proton pump inhibitor (49%), beta-blockers (32%), and opioids (21%). Approximately 90 (40%) prior-OHE patients developed recurrence 93 (30,206) days post-testing predicted only by liverrelated variables.

Discussion: Demographics, cirrhosis characteristics, and opioid use, but not other comorbid conditions, were associated with CHE diagnosis and OHE progression.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Cognition / physiology*
  • Comorbidity
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Hepatic Encephalopathy / diagnosis
  • Hepatic Encephalopathy / epidemiology*
  • Hepatic Encephalopathy / psychology
  • Humans
  • Incidence
  • Liver Cirrhosis / epidemiology*
  • Liver Cirrhosis / psychology
  • Male
  • Middle Aged
  • Psychometrics / methods*
  • Severity of Illness Index
  • Time Factors
  • Virginia / epidemiology