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Liver encephalopathy - Prognosis
Last reviewed: 04.07.2025
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The prognosis of hepatic encephalopathy depends on the severity of hepatocellular insufficiency. Patients with relatively intact liver function but with intense collateral circulation in combination with increased levels of nitrogen compounds in the intestine have a better prognosis, while those with acute hepatitis have a worse prognosis. In liver cirrhosis, the prognosis worsens in the presence of ascites, jaundice, and low serum albumin levels, the main indicators of liver failure. If treatment begins early, at the precoma stage, the likelihood of success increases. The prognosis improves if the factors contributing to the development of hepatic encephalopathy are eliminated: infection, overdose of diuretics, or bleeding.
Because of the unstable clinical course of encephalopathy, it is difficult to assess the success of therapy. The role of new treatments can be determined only after their use in a large number of patients in controlled studies. The good treatment effect in patients with chronic encephalopathy (closely associated with portocaval anastomoses) must be considered separately from the results observed in patients with acute liver failure, in which cases of recovery are rare.
Elderly patients may have additional disorders associated with cerebrovascular disease. Children with portal vein obstruction and portocaval anastomoses do not develop intellectual or mental impairment.
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