STUDY OF CLINICAL SPECTRUM AND ITS PRECIPITATING FACTORS OF HEPATIC ENCEPHALOPATHY IN CIRRHOSIS OF LIVER

Hepatic encephalopathy (HE) is a serious neuropsychiatric complication of liver cirrhosis characterized by a spectrum of cognitive and motor disturbances. It primarily results from the accumulation of neurotoxins, especially ammonia, due to impaired hepatic clearance. This observational study aimed to assess the clinical presentation, common precipitating factors, and their relationship with outcomes in patients with cirrhosis-related HE. Conducted at Meenakshi Medical College and Research Institute between December 2023 and May 2024, the study enrolled 50 patients diagnosed with HE. Clinical history, examination findings, laboratory results, and imaging were recorded. HE was graded using the West Haven classification, and liver function was assessed with the Child-Pugh score. Among the 50 participants, 68% were male, with most aged between 41 and 60 years. Constipation (42%), gastrointestinal bleeding (28%), infections (24%), and hyponatremia (26%) were the most common precipitating factors. A majority of patients presented with advanced HE, with grade III in 30% and grade IV in 28%. Mortality was highest in patients with grade IV HE (79%), with infections and gastrointestinal bleeding being the leading contributors. The findings underscore that HE frequently affects middle-aged males with advanced liver disease and that early identification and management of reversible triggers—particularly infections, gastrointestinal bleeding, and electrolyte disturbances—are crucial in improving patient outcomes. Timely interventions may significantly reduce both morbidity and mortality associated with HE in cirrhotic patients.