Patient prognosis in hepatic encephalopathy

The probability of 5 years’ survival of cirrhosis patients with hepatic encephalopathy (HE) is 16-22%, whilst cirrhosis patients without HE have 55-70%.The prognosis for patients with liver disease is that 50% of patients with minimal HE progress toward manifest HE disease within 6 months.1 Survival after first acute HE episode is estimated to be 42% at 1 year, 27% at 2 years, and 23% at 3 years.2 Patients who go into a coma have about an 80% mortality risk.3,4 Similarly, a retrospective study of 494 patients with end-stage liver disease noted that an episode of overt HE was associated with as much as a 3.9-fold increased risk of death (p<0.01).5 Even after an episode of overt HE resolves, residual cognitive impairment can be detected.6


1. Yen C, Liaw Y. Somatosensory evoked potentials and number connection test in the detection of subclinical hepatic encephalopathy.Hepato-gastroenterol. 1990;37:223-4.
2. Bustamante J et al. Prognostic significance of hepatic encephalopathy in patients with cirrhosis. J Hepatol. 1999;30:890-5.
3. Schuppan D, Afhal NH. Liver cirrhosis. Lancet. 2008;371:838-51.
4. Hepatic encephalopathy: MedlinePlus Medical Encyclopedia. US National Library of Medicine/NIH National Institutes of Health Web site. Updated October 26, 2010. Accessed November 10, 2010.
5. Stewart CA et al. Hepatic encephalopathy as a predictor of survival in patients with end-stage liver disease. Liver Transpl. 2007;13(10):1366-71.
6. Bajaj JS et al. Persistence of cognitive impairment after resolution of overt hepatic encephalopathy. Gastroenterology. 2010;138(7):2332-40.