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Hepatic encephalopathy: prognosis
Last reviewed: 23.04.2024
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The prognosis of hepatic encephalopathy depends on the severity of the liver-cell insufficiency. In patients with relatively safe liver function, but with intensive collateral circulation in combination with an increased content of nitrogenous compounds in the intestine, a better prognosis, and worse in patients with acute hepatitis. With cirrhosis, the prognosis worsens in the presence of ascites, jaundice and low serum albumin, the main indicators of liver failure. If treatment begins early, at the stage of precommission, the probability of success rises. The prognosis improves if it is possible to eliminate the factors contributing to the development of hepatic encephalopathy: infection, overdose of diuretics or bleeding.
Due to the instability of the clinical course of encephalopathy, it is difficult to assess the success of therapy. The role of new methods of treatment can be determined only after using them in a large number of patients in controlled trials. A good effect of treatment in patients with chronic encephalopathy (closely associated with portocaval anastomoses) should be considered separately from the results observed in patients with acute hepatic insufficiency, in which cases of recovery are rare.
In elderly patients, there may be additional disorders associated with cerebrovascular diseases. Children with obstructed portal veins and portocaval anastomoses do not develop violations of intelligence or mental activity.
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