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This study tested the hypothesis that serum ALB can affect the outcomes of HA infusion in hospitalised patients with cirrhosis and overt HE.
A retrospective review of medical records of 2376 cirrhotic patients without overt HE at admission revealed that 4.8% developed this complication while hospitalised; the mortality rate among the 183 cirrhotic patients with overt HE at the time of admission was 10.9%.
Age, presence of infection, levels of ammonia, and prothrombin time were identified as independent risk factors associated with development of overt HE, whereas independent predictors of in-hospital death comprised white blood cell count and total bilirubin.
Decreased ALB levels were also significantly associated with the risk of development of overt HE (≤31.6 g/l) and progression to death (≤22.8 g/l) in the context of cirrhosis. Moreover, patients with low serum ALB levels presented a higher prevalence of ascites.
Future studies should focus on long-term outcomes during follow-up as an outpatient.