Abstract:

Hepatic encephalopathy can be defined as a neuropsychiatric syndrome caused by portosystemic venous shunting, ranging from minimal to overt hepatic encephalopathy. The prevalence of hepatic encephalopathy in our setting is lacking, and the common precipitating factors of hepatic encephalopathy and outcomes after admission are not documented. The present study was conducted to study the prevalence, common precipitating factors and the outcomes of the patients.

Methods: This was a hospital based retrospective study done at Bugando medical centre referral hospital in Mwanza region. The target population were all men and women patients aged above 18 years admitted with hepatic encephalopathy at Bugando medical centre Mwanza from January 2009 to June 2015. Those who met the inclusion criteria were enrolled using a detailed checklist and analysis was done using the SPSS version 17.0.

Results: 47.7% (n=42 patients and liver cirrhosis with type C of H.E being the major cause of hepatic encephalopathy. Hepatitis B infection 22.7% (n=22.7) and 23.9% (n=21) hepatocellular carcinoma were the most prevalent causes of liver disease. The overall prevalence of hepatic encephalopathy was 0.4% among the patients admitted in that period. The population 36.4% (n=32) and 18.2% (n=16) had West Haven Grade 3 and Grade 4 respectively. The precipitating factors were of diuretic therapy 27.2% (n=44), infections 21.6% (n=35), blood transfusion 16.7% (n=27) and upper gastro intestinal bleeding 17.3% (n=28). The primary outcome was 75% (n=66) deaths and 25% (n=22) discharged. Majority of patients 72.7% (n=64) had less than 3 months survival duration after diagnosis and 27.3% (n=24) survived more than 1 year.

Conclusions: Hepatic encephalopathy is common in our area with patients usually diagnosed late, this raises challenges in the overall treatment, care and patients’ outcomes. Strategies on the early detection of H.E, precipitants and treatment may help improve its outcomes.