P- 17 FRAILTY AND COVERT HEPATIC ENCEPHALOPATHY IN CIRRHOTIC PATIENTS AT A THIRD LEVEL HOSPITAL IN GUATEMALA

Introduction and Objectives

In Guatemala, liver cirrhosis has a mortality rate of 41 per 100,000 inhabitants. Diminished physical reserve (frailty) is an important prognostic factor, largely determined by sarcopenia, which in turn has a role in the pathophysiology of hepatic encephalopathy. This study aimed to describe the relationship between frailty and covert hepatic encephalopathy to determine if cirrhotic patients with a higher degree of frailty have a higher probability of encephalopathy.

Materials and Methods

Cross-sectional analytical study with a non-probabilistic registry of consecutive cases with a statistical power of 80% and a confidence level of 90%. Patients with a diagnosis of cirrhosis without evident hepatic encephalopathy and without motor or neurocognitive impairment are included. Frailty status (prediction variable) was measured using the liver frailty index “Liver Frailty Index TM” and the one-minute animal naming test “ANT test” (outcome variable) was performed. These variables were analyzed using the chi square linearity test.

Results

66 patients with cirrhosis were included, 61% female, with a mean age of 56 years; the main causes of cirrhosis found were alcohol (25.8%), Virus C (19.7%) and liver non-alcoholic fat (16.6%). Only 7.6% of the patients were robust, while 60.6% were pre-frail and 31.8% were frail. 56.1% of the patients presented with covert hepatic encephalopathy. Robust patients presented covert hepatic encephalopathy in 20%, pre-frailty in 55% and frail in 66.7% (p = 0.087), which resulted in a probability of covert hepatic encephalopathy for pre-frailty of 2.75, CI 90% [ 0.61-12.2] and for frailty 3.33 CI 90% [0.74-14.83].

Conclusions

In cirrhotic patients, frailty confers a greater probability of hepatic encephalopathy.

Table 1. Frailty and covert hepatic encephalopathy