History of Depression is Associated With Higher Prevalence of Hepatic Encephalopathy in Patients With Advanced Liver Disease - 13/06/24
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Abstract |
Background |
Depression and hepatic encephalopathy are common in patients with advanced liver disease. Although these are distinct entities, they share several clinical features. In this analysis, we evaluated whether having a history of depression was associated with developing hepatic encephalopathy in patients with advanced liver disease.
Methods |
We performed a retrospective cohort study of patients with cirrhosis referred for liver transplant. Patients were categorized into 1 of 2 groups: “history of depression” or “no history of depression.” Multivariable logistic regression was used to evaluate history of depression as a potential independent predictor of hepatic encephalopathy.
Results |
A total of 447 patients were included, of which 158 (35%) had a history of depression and 233 (52%) had experienced hepatic encephalopathy. Hepatic encephalopathy was more common in patients with a history of depression (63% vs 46%, P < .01). On multivariate analyses, depression history was independently associated with hepatic encephalopathy (aOR 2.3, 95% CI 1.4-3.6), along with alcohol associated cirrhosis (aOR 2.0, 95% CI 1.3-3.2), history of ascites (aOR 3.5, 95% CI 2.1-5.9) and presence of a trans-jugular intra-hepatic shunt (aOR 9.2, 95% CI 2.6-32.6). The relationship between history of depression and hepatic encephalopathy remained significant in a subgroup of patients with alcohol associated liver disease (P = .04). Among those with a history of depression, SNRI prescription was more common in the hepatic encephalopathy group (14% vs 3%), and SNRI prescription was as an independent predictor of hepatic encephalopathy in the multivariable model (OR 4.8, 95% CI 1.0-24.6)
Conclusions |
Patients with a history of depression were significantly more likely to experience hepatic encephalopathy. Patients with cirrhosis who have a history of depression should be closely monitored for the development of hepatic encephalopathy. Further research is needed to understand the nuances of this relationship and whether the use of certain psychiatric medications may modify the relationship between depression and hepatic encephalopathy.
Le texte complet de cet article est disponible en PDF.Keywords : Alcohol associated, Cirrhosis, Depression, Hepatic Encephalopathy, Liver disease, Major depressive disorder
Plan
| Funding: This work was completed without grant support or other funding. |
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| Conflicts of Interest: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: DD receives grant funding from Sequana Medical for a clinical trial unrelated to the present work and grant funding from the NIAAA for research unrelated to this work. All other authors have no conflicts of interest to report. |
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| Authorship: KMC: Conceptualization, Investigation, Project administration, Formal analysis, Methodology, Supervision, Visualization, Writing – original draft, Writing – review & editing. AC: Conceptualization, Investigation, Writing – original draft, Writing – review & editing. BO: Writing – review & editing. EH: Writing c review & editing. AT: Conceptualization, Methodology, Resources, Supervision, Writing – review & editing. DD: Conceptualization, Formal analysis, Methodology, Resources, Supervision, Writing – review & editing |
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