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Original Research

RMJ. 2014; 39(2): 115-118

Factors associated with nonresponse to lactulose in patients with cirrhosis and hepatic encephalopathy

Muhammad Omar Qureshi, Farzana Shafqat, Mohammad Salih, Nasir Khokhar.

Objective: To evaluate the factors associated with non response to lactulose in patients with liver cirrhosis and hepatic encephalopathy (HE).
Design: Prospective non interventional.
Place and Duration of Study: Shifa International Hospital, Islamabad from August 2011 to February 2013.
Methods: A total of 250 patients with liver cirrhosis and hepatic encephalopathy were included. Patients were treated with lactulose. Nonresponse was defined if patient remained in HE after 10 days of treatment or died while in HE. The data was analyzed using SPSS v 16. Chi square test was used to assess categorical variables and Student T test for continuous variables.
Results: Out of total patients with hepatic encephalopathy, 193 (77.2%) responded to lactulose vs 57(22.8%) patients which did not respond. Patients not responding to lactulose had high MELD,CTP score,TLC, ammonia levels, low platelets and sodium levels in comparison to lactulose responsive patients (p < 0.001).
Conclusion: Majority of patients with HE responded to lactulose. High baseline MELD,CTP score, total leukocyte count, ammonia levels, creatinine levels and low serum sodium levels were associated with nonresponse to lactulose.

Key words: Hepatic encephalopathy, Liver cirrhosis, Lactulose

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