Factors Associated With Progression, Resolution and Mortality of Patients With Overt Hepatic Encephalopathy
Bibliographic record
Abstract
Background Overt hepatic encephalopathy (OHE) is a reversible complication of cirrhosis that often results in hospitalization. Factors associated with progression, resolution and mortality are not known, particularly with confounders such as acute-on-chronic liver failure (ACLF). The aim of the study was to evaluate factors associated with progression, resolution, and mortality of patients with OHE. Methods Data for this study were derived from PREDICT, a prospective cohort study of patients with cirrhosis hospitalized for an acute decompensation or ACLF. Progression to OHE or worsening in severity and resolution from OHE were evaluated at 1 week. Cox regression, interaction analyses, and Kaplan–Meier curves were performed. Results One thousand two hundred seventy-three patients were included [68% males; 59 (51–67) years; 56% alcohol], 16% admitted with OHE and 16% with ACLF. Older age, metabolic dysfunction-associated steatotic liver disease, previous treatment with lactulose, ACLF, white blood cell counts or albumin levels at admission were associated with OHE ( P < 0.05). OHE progressed in 3% patients, which was associated with older age, previous treatment with lactulose and bacterial infections ( P < 0.05), with a significantly shorter time-to-death ( P < 0.001). Patients who resolved OHE (79%) presented a similar prognosis than those without OHE ( P = 0.208). Post hoc analysis of the age-adjusted interaction between OHE and ACLF to predict mortality showed higher differences across ACLF grades compared with OHE. Conclusion Presence of ACLF and progression of OHE are associated with high short-term mortality rates, while resolution of OHE is associated with significantly better prognosis. Understanding the natural history of OHE will have profound implications on the development of novel approaches.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".