ArticleAlimentary pharmacology & therapeutics2020
Outcomes after hepatic encephalopathy in population-based cohorts of patients with cirrhosis.
Article in Alimentary pharmacology & therapeutics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed, 3 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- [Guidelines for diagnosis and treatment of liver failure (2024 version)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Guideline
- Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis.The Cochrane database of systematic reviews · 2023Pooled it
- Malnutrition, Frailty, and Sarcopenia in Patients With Cirrhosis: 2021 Practice Guidance by the American Association for the Study of Liver Diseases.Hepatology (Baltimore, Md.) · 2021Guideline
- Changes in Inpatient Coding for Hepatic Encephalopathy After Introduction of ICD-10 Code K76.82.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Multi-organ non-contrast computed tomography radiomics model to predict hepatic encephalopathy in patients with cirrhosis and hepatorenal failure.Diagnostic and interventional radiology (Ankara, Turkey) · 2026Article
- Lack of association between rifaximin and drug-resistant infections: a global multicenter inpatient cirrhosis cohort.Clinical and molecular hepatology · 2026Article
- Clinical Challenges in the Management of Hepatic Encephalopathy in Older Patients with Cirrhosis: A Nationwide Italian Physician-Reported Survey.Medicina (Kaunas, Lithuania) · 2026Article
- Rising Cardiometabolic Comorbidity and Inpatient Resource Utilization Among Hospitalized Patients with Hepatocellular Carcinoma, 2018-2022.Journal of clinical medicine · 2026Article
- Article
- Rifaximin reduces rehospitalization risk in patients with cirrhosis and overt hepatic encephalopathy.Hepatology communications · 2026Article
- Testosterone Replacement Reduces Morbidity and Mortality for Most Patients With Cirrhosis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2025Article
- Prospective observational study on systemic inflammation and prognostic significance of hepatic encephalopathy.Metabolic brain disease · 2025Observational
- A Machine Learning-Based Prognostication Model Enhances Prediction of Early Hepatic Encephalopathy in Patients With Noncancer-Related Cirrhosis: Multicenter Longitudinal Cohort Study in Taiwan.JMIR medical informatics · 2025Article
- Importance of comprehensive nutritional assessment in predicting survival in cirrhosis.World journal of hepatology · 2025Article
- Real-World Setting of Efficacy and Safety of 3 Years of Rifaximin Administration in Japanese Patients with Hepatic Encephalopathy: A Multicenter Retrospective Study.Journal of clinical medicine · 2025Article
- Hepatic encephalopathy and spontaneous bacterial peritonitis are associated with increased liver-related readmissions in cirrhosis.Frontiers in medicine · 2025Article
- Outpatient management after hospitalisation for acute decompensation of cirrhosis: A practical guide.World journal of hepatology · 2024Review
- Systems of care that improve outcomes for people with hepatic encephalopathy.Metabolic brain disease · 2024Review
- Prognosis of Cirrhotic Patients After Osteoporotic Femoral Neck Fracture.Journal of clinical medicine · 2024Article
- Racial and Ethnic Disparities in Outcomes After the Development of Ascites: A National Cohort Study.Digestive diseases and sciences · 2024Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundHepatic encephalopathy is a devastating complication of cirrhosis.
aimTo describe the outcomes after developing hepatic encephalopathy among contemporary, aging patients.
methodsWe examined data for a 20% random sample of United States Medicare enrolees with cirrhosis and Part D prescription coverage from 2008 to 2014. Among 49 164 persons with hepatic encephalopathy, we evaluated the associations with transplant-free survival using Cox proportional hazard models with time-varying covariates (hazard ratios, HR) and incidence rate ratios (IRR) for healthcare utilisation measured in hospital-days and 30-day readmissions per person-year. We validated our findings in an external cohort of 2184 privately insured patients with complete laboratory values.
resultsHepatic encephalopathy was associated with median survivals of 0.95 and 2.5 years for those ≥65 or <65 years old and 1.1 versus 3.9 years for those with and without ascites. Non-alcoholic fatty-liver disease posed the highest adjusted risk of death among aetiologies, HR 1.07 95% CI (1.02, 1.12). Both gastroenterology consultation and rifaximin utilisation were associated with lower mortality, respective adjusted-HR 0.73 95% CI (0.67, 0.80) and 0.40 95% CI (0.39, 0.42). Thirty-day readmissions were fewer for patients seen by gastroenterologists (0.71 95% CI [0.57-0.88]) and taking rifaximin (0.18 95% CI [0.08-0.40]). Lactulose alone was associated with fewer hospital-days, IRR 0.31 95% CI (0.30-0.32), than rifaximin alone, 0.49 95% CI (0.45-0.53), but the optimal therapy combination was lactulose/rifaximin, IRR 0.28 95% CI (0.27-0.30). These findings were validated in the privately insured cohort adjusting for model for endstage liver disease-sodium score and serum albumin.
conclusionsHepatic encephalopathy remains morbid and associated with poor outcomes among contemporary patients. Gastroenterology consultation and combination lactulose-rifaximin are both associated with improved outcomes. These data inform the development of care coordination efforts for subjects with cirrhosis.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.