Sotelo N, Durazo MA, Ruíz VG

Language: English
References: 15
Page: 35-38
PDF size: 100.66 Kb.

ABSTRACT

The hepatic encephalopathy (HE) is defined as wide spectrum neuropsychiatric alterations potentially reversible. Objectives: to know applicability of the modified West-Haven Scale (WHS), to correlate with neuropsychiatric signs in HE. Materials and methods: thirty three cases of HE were selected; the variables were: age, sex, type of hepatopathy, signs and symptoms (jaundice, fever, abdominal pain, vomiting, nausea and headache). Neurological signs were classified with WHS. Results: pre school children (45%). Etiology, non specific hepatitis and hepatitis A virus were predominant the neurological sign was asterixis. While correlating neurological signs and WHS, the Pearson’s X² test was P=0.0006, the coefficient of determination R² 0.5382, equivalent to a correlation coefficient › 72%. While comparing WHS and mortality, it was associated to higher grades of the scale, Fisher‘s test P=0.495. The mortality was 71.8%. Conclusion: the WHS has adequate correlation with the neurological signs in children and grades of the scale are also related to mortality.

REFERENCES

1. Debray D, Cullufi P, Devictor D, Fabre M, Bernard O. Liver failure in children with hepatitis A. Hepatology 1997; 26(4): 1018-22.

2. Cochrean JB, Losek JD. Acute failure in children. Pediatr Emerg Care 2007; 23(2): 129-35.

3. Lizardi-Cervera J, Almeda P, Guevara L, Uribe M. Hepatic encephalopathy; A review. Ann Hepatol 2003; (3): 122-30.

4. Romero-Gómez M, Boza F, García-Valdecasas MS, García E, Aguilar-Reina J. Sub clinical hepatic encephalopathy predict the development of overt hepatic encephalopathy. Am J Gastroenterol 2001; (9): 2718-23.

5. O’Grady JG, Schalman SW, Williams R. Acute liver failure: redefining the syndromes. Lancet 1993; 342: 273-275.

6. Software JMP Version 7.0.7 (Academic) SAS Institute Inc, Cary NC, USA; 2008.

7. Valdespino JL, Ruíz-Gómez J, Olaiz-Fernández G, Arias-Toledo E, Conde-González CT, Palma O, Sepúlveda J. Seroepidemiología de la hepatitis A en México. Sensor de inequidad social e indicador de políticas de vacunación. Salud Pública México 2007; 49(S3): 377-85.

8. Montaño A, Barañano R, Lacerad B, Moratorio G, Dibarboure H, García, et al. Prevalencia de hepatitis A en niños de 2 a 14 añosy en población laboral de18 a 49 años en Montevideo Uruguay. Rev Med Uruguay 2001; 17: 84-98.

9. Fontana RJ. Acute liver failure including acetaminophen overdose. Med Clin N Am 2008; 92: 761-94

10. Vaquero J, Chung Ch, Blei AT. Brain edema in acute liver failure. A window to the pathogenesis of hepatic encephalopathy. Ann Hepatol 2003; 2(1): 12-25.

11. Velasco F, Gómez JC, Zarranz LL, Lambarri I, Ugalde J. Asterixis en lesiones focales . Neurología 2004; 19(4):225-19.

12. Poo JL, Góngora J, Sánchez-Avila F, Aguilar-Castillo S, García- Ramos G, Fernández-Zertuche M, Rodríguez-Fragoso L, Uribe M. Efficacy of oral L-ornithine, L-aspartate in cirrhotic patients with hyperammonemic hepatic encephalopathy. Results randomized, lactulose controlled study. Ann Hepatol 2006; 5(4) 281-8.

13. Ben-Ari Z, Vakin H, Tur-Kaspa R. N-acetylcisteine in acute hepatic failure (non-paracetamol induced). Hepatol Gastroenterol 2000; 47:786-9.

14. Méndez-Sanchez N, Chávez-Tapia NC, Espinoza B, Herrera-Gomar M, Zamora-Valdez D, Uribe M. Acute liver failure and the molecular adsorbents recirculating system: early experience in a tertiary care hospital in México city. Ann Hepatol 2004; 3(4): 164-6.

15. Khan AW, Fuller BJ, Shah SR, Davidson BR, Rolles K. A prospective randomized trial of N-acetylcysteine administration during cold preservation of the donor liver for transplantation. Ann Hepatol 2005; 4(2): 121-6.