Prevalence And Precipitating Factors Of Hepatic Encephalopathy In Patients With Liver Cirrhosis And Ascites Admitted At Korle Bu Teaching Hospital In Ghana

Abstract

Background: Hepatic encephalopathy (HE) is one of the most debilitating complications of cirrhosis leading to death and severely affects the lives of patients and their caregivers. Decreases in HE mortality and recurrence have been linked with timely identification and correction of potential precipitating factors and early treatment. The aim of this study was therefore to determine the prevalence and precipitating factors of patients with cirrhotic ascites admitted with overt hepatic encephalopathy at KBTH Accra, Ghana.
Materials and Methods: A cross-sectional study was conducted involving one hundred and three (103) patients admitted at medical block in the Korle-Bu Teaching Hospital (KBTH) with cirrhotic ascites from 25th March 2016 to 25th November, 2016. Demographic and clinical features including features of overt hepatic encephalopathy and possible precipitant were collected using a standardized questionnaire. 
Results: One hundred and three patients with cirrhotic ascites were recruited for the study with a mean age of 43.5 ± 12.2 years. Fifty-eight (56.3%) patients were males. The prevalence of hepatic encephalopathy was 25.24%. Precipitating factors were infections (53.8%),
gastrointestinal bleeding (19.2%), electrolyte imbalance (9.2%) and constipation (3.9%). No precipitant was identified for one patient with hepatic encephalopathy.
Conclusion: Prevalence of overt hepatic encephalopathy in patients with liver cirrhosis and ascites is not uncommon in our setting and precipitants were identified for almost all of them except one patient. A similar study should be done on a larger scale in multiple centres and regions to get a well-balanced prevalence of hepatic encephalopathy and its precipitating factors.