Abstract

A PROSPECTIVE OBSERVATIONAL STUDY ON MORTALITY, RISK FACTOR AND MANAGEMENT OF ENCEPHALOPATHY IN TERTIARY CARE HOSPITAL

*Rajesh, Shekhar Yadav, B. R. Prabhudev and Balakeshwa Ramaiah

ABSTRACT

Background: Septic and Hepatic encephalopathies are the multifactorial syndrome commonly occurring in ICU settings with patients having sepsis and metabolic derangement. It is an exclusional diagnosis. This study aims to assess the mortality, risk of development and management in patients diagnosed with Septic and Hepatic encephalopathy. Materials and method: During observational study, total of 50 patients with encephalopathies either gender or age group presenting complaints of altered sensorium, abdomen pain and yellowish discoloration of sclera and body were included. A detailed demographic and history were taken with laboratory reports and diagnostic tests were done, GCS was used to asses mental status of patients and SOFA score was used to predict mortality in patients, the pattern of drug use in different encephalopathies were collected, documented and analysed. Results: Total of 50 patients 35 were male and 15 were female, 21 patients were less than 60 years of age and 29 patients were geriatric population. Among them 30 patients were diagnosed with septic encephalopathy and 20 patients were hepatic encephalopathy. Six patients were having mortality of 60-90% (4 Died), 19 patients had mortality rate of 30-60% (6 Died), 22 patients had mortality rate of 0-30% (2 Died) and 3 patients had mortality of more than 90%. Sepsis (100%), HTN (96%), DM (96%) were major risk factor in Septic encephalopathy. Alcohol (92%), CLD (92%), HTN (76%) and DM (76%) were major risk factor in Hepatic encephalopathy. Antibiotics like Rifaximin, Ceftriaxone, piperacillin tazobactam were mostly seen in prescription. Dietary supplements like thiamine, Lactulose were mostly used. Conclusion: From the study, it has been concluded that elderly aged patients diagnosed with sepsis and metabolic derangements are high likely to get encephalopathy. Sepsis, HTN, DM, alcoholic liver disease and CLD were major risk factors. SOFA scale was helpful in accessing the mortality in patients, but it was not associated with the length of hospital stay. Significant difference was observed in lab reading among Septic and Hepatic encephalopathy patients.

Keywords: Sepsis, encephalopathy, mortality, Geriatric, hepatic.