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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Mariadi, Ketut
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Medicine & Pharmacology

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Hepatic Encephalopathy Scoring Model in Hepatic Cirrhosis Based on Clinical and Laboratory Parameter Pamungkas, Kadek Mercu Narapati; Lesmana Dewi, Putu Itta Sandi; Dewi, Ni Luh Putu Yunia; Kharisma Dewi, Ni Nyoman Gita; Sindhughosa, Dwijo Anargha; Mariadi, Ketut
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 3 (2024): VOLUME 25, NUMBER 3, December, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/253202416-23

Abstract

Background: Hepatic Encephalopathy (HE) is a serious complication with a wide spectrum of clinical symptoms, from minimal changes to profound coma. HE is hard to diagnose without advanced laboratory parameters such as ammoni. This study aims to develop a scoring model to diagnose HE using clinical and laboratory parameters. Methods: An analytical cross-sectional study collected data from 96 hospitalized patients with liver cirrhosis from November 2021 to January 2022. Employing multivariate logistic regression analysis, the study aimed to identify autonomous factors associated with HE. Each significant variable was used to calculate patient probabilities. The score for each variable was computed utilizing the (B/SE)/lowest(B/SE) formula, demonstrating robust discriminatory capability. The scoring model was formulated and evaluated based on its sensitivity and specificity.Results: Nineteen point eight percent, equivalent to ninenteen patients, were admitted with HE. The scoring model was crafted based on nineteen variables. There were four significant variables in this model: Aspartate Aminotransferase (AST) (p=0.01), Total Bilirubin (p=0.007), Fibrosis-4-Index (FIB-4) (p=0.014), and Ascites (p=0.016). Each variable was scored as 1 for AST, -1 for total bilirubin, 1 for FIB-4-index, and 1 for Ascites. The probability was 2%, 14.2%, 57%, 91.4%, and 50%, following the total score of -1, 0, 1, 2, and 3, respectively. The sensitivity and specificity of the scoring model were 68.4% and 85.3%, respectively (AUC=84.7%).Conclusion: Daily laboratory and clinical manifestations related to hepatic cirrhosis could give a clue to diagnosing hepatic encephalopathy. 
The Neutrophil Percentage-to-Albumin Ratio (NPAR) is Associated with In-Hospital Mortality in Patients with Liver Cirrhosis Lastiana, Ni Made Putri; Mariadi, Ketut; Sindhughosa, Dwijo Anargha; Kumar, Manoj
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 2 (2025): VOLUME 26, NUMBER 2, AGUSTUS, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2622025101-106

Abstract

Background: Studies show that the Neutrophil Percentage-to-Albumin Ratio (NPAR) predicts mortality in a number of illnesses. On the other hand, there is currently limited clinical support for using NPAR in liver cirrhosis patients. Investigating the associated of NPAR and hospital mortality outcome patients with liver cirrhosis is the goal of this study.Methods: All cirrhosis patients who were admitted to the hospital were included in this retrospective cohort analysis. The percentage of neutrophils and albumin levels on the first day of hospitalization were compared to determine the NPAR. Data were analyzed using the Mann-Whitney test, operating curve (ROC) analysis, and Kaplan-Meier survival curves. P-value 0.05 was considered statistically significant. Results: This study included 98 patients with liver cirrhosis. It was found that NPAR had a high incidence of patient mortality compared to surviving patients who were hospitalised (35.13 vs. 25.33, p 0.001). The median overall survival for all subjects was 10 days, indicating that 50% of the subjects had died within 10 days. According to ROC analysis, NPAR has an ideal cutoff value of 29.63 and can be utilized as a predictor of in-hospital mortality (sensitivity 74.1%, specificity 72.7%, AUC 0.8, p 0.001). Survival analysis stratified by NPAR showed that patients with NPAR ≥ 29.63 had a lower median survival compared to those with NPAR 29.6.Conclusion: In patients with liver cirrhosis, the Neutrophil Percentage-to-Albumin Ratio (NPAR) is a metric that can be used to assess in-hospital mortality outcomes
Co-Authors Dewi, Ni Luh Putu Yunia Dwijo Anargha Sindhughosa, Dwijo Anargha Kharisma Dewi, Ni Nyoman Gita Kumar, Manoj Lastiana, Ni Made Putri Lesmana Dewi, Putu Itta Sandi Pamungkas, Kadek Mercu Narapati