Journal Article

P: 42 To Assess Frequency of Hepatic Encephalopathy in Spontaneous Bacterial Peritonitis Patients

Hassan, Adil, Bughio, Ubedullah, Bhatti, Rehmatullah, Iqbal, Javed, Ali, Mohsin, Hafeez, Abdul, Ali, Mashooque

2019

Overview

BACKGROUND:Hepatic encephalopathy (HE) is a commonly encountered complication in cirrhotics. The incidence of HE ranges from 2% to 20% per year in patients with liver cirrhosis. HE is associated with increased morbidity and mortality as well as significant utilization of health care resources. Most cases of significant HE are precipitated by gastrointestinal bleeding, infection, constipation, electrolyte imbalance and medications. Spontaneous bacterial peritonitis (SBP) is an independent predictor of HE. We evaluated frequency of HE in SBP patients.METHODS:This cross-sectional study was conducted at the Gastro-hepatology section of Asian Institute of Medical Sciences in Hyderabad, Pakistan from April 2017 to March 2019. 120 Patients with paracentesis-proven SBP [Absolute Neutrophils counts (ANC) >250/mm3], aged from 18 to 80 years were included. Frequency of HE evaluated.RESULTS:A total of 120 patients of SBP with mean age 47.80 years, with 88 (73.3%) males and 32 (26.7%) females were examined. Most common serology was HCV (61.7%). 21 were CTP B (17.5%) and 99 were Child C (82.5%). HE was present in 75 (62.5%) with most common grades were II (29.33%) and III (29.33%) and IV (21.33%). Mean ANC 5086, 96 (80%) were PPI users and 64.58% have HE.CONCLUSIONS:Hepatic encephalopathy has strong association with SBP and PPI use. Screening for asymptomatic SBP in all patients with HE should be considered and over-the-counter PPI use should be restrained.

• Publisher: Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
• Subject: Peritonitis