Infectious Disease Hospital, Fujian Medical University, Fuzhou 350025, China.
To investigate the risk factors of hepatic encephalopathy in patients with liver failure. Nine-hundred-and-seventy-six hepatitis B virus (HBV) patients with liver failure were retrospectively analzyed. Clinical data (sex, age, family history, liver cirrhosis, diabetes, celiac infection, pulmonary infection, liver kidney syndrome, upper gastrointestinal hemorrhage) and laboratory findings (albumin, globulin, total bilirubin, direct bilirubin, alanine aminotransferase, aspartate aminotransferase (AST), gamma-glutamyl transferase, alkaline phosphatase, cholesterol, cholinesterase, K+, Na+, creatinine, international normalized ratio (INR), alpha-fetoprotein, HBV DNA, white blood cell, hemoglobin, platelet) were collected and used to screen the risk factors for hepatic encephalopathy by univariate and multiple regress analyses. Multiple logistic regression analysis indicated that upper gastrointestinal hemorrhage [risk (R) = 0.993, relative hazard (RH) = 2.699, 95% confidence interval (CI): 1.567-4.651], pulmonary infection [R = 1.043, RH = 2.839, 95% CI: 1.680-4.797], INR [R = 0.257, RH = 1.293, 95% CI: 1.220-1.370], AST level [R = 0.001, RH = 1.001, 95% CI: 1.000-1.001], and cirrhosis [R = 0.569, RH = 1.815, 95% CI: 1.112-2.965] were closely correlated with hepatic encephalopathy. HBV-infected patients presenting with upper gastrointestinal haemorrhage, pulmonary infection, prolonged INR, elevated AST, or liver cirrhosis should be carefully monitored for indications of hepatic encephalopathy to initiate timely therapeutic interventions.