Prospective Multicenter Observational Study of Overt Hepatic Encephalopathy.
In: Digestive Diseases & Sciences, Jg. 61 (2016-06-01), Heft 6, S. 1728-1734
Online
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Zugriff:
Background: Overt hepatic encephalopathy (OHE) is a frequent complication of decompensated cirrhosis. Aims: A multicenter prospective observational study was performed to assess the most commonly recorded presenting manifestations of OHE and its associated health-care burden. Methods: Qualifying patients must have experienced ≥1 OHE episode within 30 days of enrollment (qualifying OHE) and were followed for recurrence (on-study OHE). Results: Two hundred and sixty-five patients were enrolled at 30 sites and followed for up to 9 months (mean 72 days). Seventy-two patients experienced 122 on-study episodes; with 72, 23, and 13 having ≥1, ≥2, or ≥3 on-study episodes with median days to occurrence of the 1st, 2nd, and 3rd episode of 34, 19, and 11, respectively. The most frequently recorded OHE manifestations included confusion (78 %), change in mental status (57 %), disorientation (48 %), lethargy (46 %), and asterixis (45 %). West Haven grade was used inconsistently and recorded for only 28 % of episodes. Most qualifying and on-study episodes occurred on rifaximin (60 and 82 %, respectively) and were associated with hospitalization (68 and 85 %, respectively). Twenty-three patients experienced ≥2 on-study episodes within 2 months of enrollment on average (median 45 days) and accounted for 60 % of on-study episodes. Conclusions: In this prospective study, OHE's most commonly recorded presenting manifestations included confusion, altered mental status, disorientation, lethargy, and asterixis. As reflected by frequent recurrence and hospitalizations, OHE, particularly the approximately 10 % of "high-resource-utilizing" patients with frequent recurrence, continues to pose a major unmet medical need and health-care burden despite the use of rifaximin. [ABSTRACT FROM AUTHOR]
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Prospective Multicenter Observational Study of Overt Hepatic Encephalopathy.
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Autor/in / Beteiligte Person: | Landis, C. ; Ghabril, M. ; Rustgi, V. ; Bisceglie, A. ; Maliakkal, B. ; Rockey, D. ; Vierling, J. ; Bajaj, J. ; Rowell, R. ; Santoro, M. ; Enriquez, A. ; Jurek, M. ; Mokhtarani, M. ; Coakley, D. ; Scharschmidt, B. ; Landis, C S ; Di Bisceglie, A M ; Rockey, D C ; Vierling, J M ; Coakley, D F |
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Zeitschrift: | Digestive Diseases & Sciences, Jg. 61 (2016-06-01), Heft 6, S. 1728-1734 |
Veröffentlichung: | 2016 |
Medientyp: | academicJournal |
ISSN: | 0163-2116 (print) |
DOI: | 10.1007/s10620-016-4031-7 |
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