IN-HOSPITAL MORTALITY AND LIPID PROFILE IN PATIENTS WITH HEPATIC ENCEPHALOPATHY: A STUDY FROM A TERTIARY CARE HOSPITAL IN KARACHI

Abstract

Background: Hepatic encephalopathy (HE) poses a major challenge in the management of chronic liver disease and contributes significantly to in-hospital mortality. In low-resource settings, identifying simple and affordable predictors of poor outcomes remains crucial. This study examined the frequency of in-hospital mortality among patients with HE and explored the association between lipid profiles, disease severity, and survival. Methods: We carried out a descriptive cross-sectional study over six months at the Department of Medicine, Jinnah Postgraduate Medical Centre, Karachi. We enrolled 112 patients aged 40–80 years who presented with HE within 24 hours of admission. We excluded patients with comorbid conditions likely to confound outcomes. We recorded demographic data, clinical grade of encephalopathy, and lipid profile values, and compared these variables between survivors and non-survivors. Results: In-hospital mortality occurred in 45.5% of patients. All patients with Grade 4 HE died, and over half of those with Grade 3 also did not survive. Patients who died showed significantly lower levels of cholesterol, LDL, HDL, and triglycerides compared to survivors (p = 0.01 for all). None of the patients with Grade 1 or 2 HE died. Conclusion: Patients with advanced hepatic encephalopathy faced a high risk of in-hospital mortality. Lower lipid levels, particularly reduced HDL and total cholesterol, were strongly linked to fatal outcomes. These findings suggest that routine lipid profiling may offer a practical and inexpensive tool to support early risk stratification in clinical settings where more complex scoring systems are not readily available.