TY - JOUR
T1 - Prevalence and prognostic value of quantified electroencephalogram (EEG) alterations in cirrhotic patients
AU - Amodio, Piero
AU - Del Piccolo, Franco
AU - Pettenò, Elena
AU - Mapelli, Daniela
AU - Angeli, Paolo
AU - Iemmolo, Rosamaria
AU - Muraca, Maurizio
AU - Musto, Carmine
AU - Gerunda, Giorgio
AU - Rizzo, Cristiano
AU - Merkel, Carlo
AU - Gatta, Angelo
PY - 2001
Y1 - 2001
N2 - Background/Aims: The electroencephalogram (EEG) is frequently altered in cirrhotic patients. We, therefore, performed a study to ascertain the features and the prognosis of cirrhotic patients without current overt hepatic encephalopathy (OHE) who have EEG alterations. Methods: A series of 296 consecutive cirrhotic patients who had undergone quantified-EEG was studied. The median follow-up was 442 days, 128 patients had bouts of OHE and 78 patients died from liver-related causes. Another group of 124 cirrhotic patients with a median follow-up of 223 days was examined to validate the prognostic model. Results: EEG alterations were detected in 38% of the patients. The prevalence of EEG alterations was associated with the severity of cirrhosis (class B: odds ratio (OR) = 2.3, 95% confidence interval (CI) = 1.2-4.7; class C: OR = 3.5, 95% CI = 1.6-7.7), but not with the aetiology (alcoholic vs. non-alcoholic: OR = 0.9; 95% CI = 0.5-1.5). The EEG predicted the occurrence of OHE (X2 = 26; P <0.001) and mortality (X2 = 34; P <0.001), also adjusting for Child-Pugh class by a multivariate analysis. In the patients with a Child-Pugh score of ≥ 8, the EEG discriminated between those patients with a higher 1-year risk of OHE (hazard ratio (HR) = 3.3, 95% CI = 1.8-6.1) and death (HR = 3.1, 95% CI = 1.7-5.6). Conclusions: In conclusion, quantified-EEG had a prognostic value for the occurrence of bouts of OHE and mortality in cirrhotic patients.
AB - Background/Aims: The electroencephalogram (EEG) is frequently altered in cirrhotic patients. We, therefore, performed a study to ascertain the features and the prognosis of cirrhotic patients without current overt hepatic encephalopathy (OHE) who have EEG alterations. Methods: A series of 296 consecutive cirrhotic patients who had undergone quantified-EEG was studied. The median follow-up was 442 days, 128 patients had bouts of OHE and 78 patients died from liver-related causes. Another group of 124 cirrhotic patients with a median follow-up of 223 days was examined to validate the prognostic model. Results: EEG alterations were detected in 38% of the patients. The prevalence of EEG alterations was associated with the severity of cirrhosis (class B: odds ratio (OR) = 2.3, 95% confidence interval (CI) = 1.2-4.7; class C: OR = 3.5, 95% CI = 1.6-7.7), but not with the aetiology (alcoholic vs. non-alcoholic: OR = 0.9; 95% CI = 0.5-1.5). The EEG predicted the occurrence of OHE (X2 = 26; P <0.001) and mortality (X2 = 34; P <0.001), also adjusting for Child-Pugh class by a multivariate analysis. In the patients with a Child-Pugh score of ≥ 8, the EEG discriminated between those patients with a higher 1-year risk of OHE (hazard ratio (HR) = 3.3, 95% CI = 1.8-6.1) and death (HR = 3.1, 95% CI = 1.7-5.6). Conclusions: In conclusion, quantified-EEG had a prognostic value for the occurrence of bouts of OHE and mortality in cirrhotic patients.
KW - Cirrhosis
KW - Electroencephalogram
KW - Hepatic encephalopathy
KW - Spectral electroencephalogram analysis
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=0034933478&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034933478&partnerID=8YFLogxK
U2 - 10.1016/S0168-8278(01)00129-5
DO - 10.1016/S0168-8278(01)00129-5
M3 - Article
C2 - 11495040
AN - SCOPUS:0034933478
SN - 0168-8278
VL - 35
SP - 37
EP - 45
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 1
ER -