DefinePK

Abstract

Introduction: Liver cirrhosis and its complications are associated with morbidity and mortality worldwide. Hepatic encyclopathy is associated with various predisposing factor including electrolyte disturbances.The purpose of our study was to evaluate the effect of serum sodium and potassium imbalances on the outcomes of hepatic encephalopathy (HE) in patients with hepatitis C virus (HCV) related cirrhosis.\nMethod: This cohort study was conducted at the Department of Medicine, Holy Family Hospital, Rawalpindi during 2022. A total of 158 patients with HE complicating HCV-related cirrhosis were included. HE was diagnosed based on the West Haven criteria. Each patient was managed in a standardized manner. In addition to age and gender, HE grades, serum sodium (Na+), potassium (K+) levels, Child-Turcotte-Pugh (CTP) score, and any comorbidities if present were noted. These factors were correlated with outcomes i.e., improvement in one grade of HE from presentation. Mortality and Duration of hospital stay at the 14th day of admission, employing chi-square tests for categorical variables and independent t-tests for continuous variables. A p-value of <0.05 was considered significant.\nResults: Out of 158 patients, female patients were 53.79% and rest were male. Male to female ratio was 1:1.16. Mean patient age was 47.96 ± 8.95 years. Among this cohort, 63.9% patients were diabetic, 29.7% were hypertensive, and 6.3% had history of stroke. At the time of admission, 48.1% patients were in Grade II, 22.8% in Grade I, 19.6% in Grade III, and 9.5% in Grade IV HE. Patients who were categorized to Child Class C were 99.4%. At the time of admission, mean serum sodium and potassium level were 143.40 ± 9.22 mmol/L and 4.79 ± 3.83 mmol/L respectively. Patients who improved were 70.9% and who expired were29.1%. Upon admission, patients who did not survive had significantly higher sodium and potassium levels upto 146.21 ± 10.5, and 4.8 ± 0.5 mmol/L compared to those who improved 142.25 ± 8.40, and 4.35 ± 0.6 respectively. P-value was <0.05.\nConclusion: At admission higher sodium and potassium levels corelate significantly with poor outcome in HCV related patients with cirrhosis.