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Published on: June 26, 2020
Bacterial infections associated with hepatic encephalopathy: prevalence and outcome
Edna Strauss1, Maria de Fátima Gomes de Sá Ribeiro
1Clinic of Gastroenterology, Heliopólis Hospital; School of Medicine-University of Säo Paulo, Av. Dr. Eneas de CArvalho Aguiar, 177-10o andar, CEP: 05403-000 Säo Paulo, Brazil. edna.strauss@hcnet.usp.br
Abstract:
Hepatic encephalopathy (HE) is a major sign of severe liver disease and the impact of associated bacterial infections should be better evaluated. A retrospective cohort of 333 patients with cirrhosis and HE was analyzed in three periods of time, from 1984 to 1998. Variance analysis, Wilcoxon, Chi-square and Fisher's exact tests were used for statistical comparisons. Prevalence of bacterial infections decreased along the time (p = 0.0029). Spontaneous Bacterial Peritonitis -SBP- (37%) and urinary tract infection (30%) were the more frequent types of bacterial infections. Early death was significantly higher in HE with infection (46,47%) and the calculated RR was 2.047. Prognosis was worse in septicemia (79%) and respiratory tract infection (50%) and better in urinary tract infection (27%). SBP lethality was reduced from 70% to 38% (p = 0.062). In conclusion, lower prevalence of bacterial infections, in severe liver disease, was achieved in the last decade, but short-term prognosis remains bad, varying according to the type of bacterial infection.
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