Correlation of serum sodium with severity of hepatic encephalopathy in liver cirrhosis patients presenting at Dr. Ruth K.M. Pfau Civil Hospital Karachi.

Abstract

Introduction: Cirrhotic patients suddenly or insidiously develop hepatic en-cephalopathy. Approximately three-fourth of the patients usually die within 3 years of onset of their first episode of hepatic encephalopathy. Hypo-natremia, a multifactorial phenomenon in cirrhotic patients may lead to cer-ebral edema and astrocytes swelling.
Objective: To determine the correlation of serum sodium with severity of hepatic encephalopathy in liver cirrhosis patients presenting at tertiary care hospital, Karachi.
Methodology: This prospective cross-sectional study conducted at Depart-ment of Medicine, Civil Hospital, Karachi between October 31, 2019 till April 4,2020. Data collected from 138 patients after taking written consent; pre-sented as was as mean, standard deviation, frequency and percentages. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable taking p-value of ≤0.05 as significant.
Results: Among 138 patients 92 (66.7%) were male and 46 (33.3%) were female. Mean age, duration of symptoms, height, weight and serum sodium in our study was 51.14±4.49 years, 12±7.21 hours, 161±6.78 cm, 85.2±8.54 kg and 132.7±6.32 mEq/L. Out of 136 patients, 28 (20.3%), 35 (25.4%), 54 (39.1%) and 21 (15.2%) patients belonged to sodium quartile 1, 2, 3 and 4; while 21 (15.2%), 41 (29.7%), 28 (20.3%) and 48 (34.8%) belonged to hepatic encephalopathy severity grade 1, 2, 3 and 4. Hepatic encephalopathy severi-ty showed correlation with rising sodium levels.
Conclusion: Hyponatremia was found with increased frequency in patients with cirrhosis of liver having a correlation with frequency and severity of hepatic encephalopathy.
Key words: Encephalopathy, Liver Cirrhosis, Hyponatremia.