{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:42:49Z","timestamp":1790073769210,"version":"4.0.1"},"reference-count":52,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Management of hepatic encephalopathy relies on the identification and control of precipitating factors (PF). The prognostic value of a PF is unknown, which we aimed to explore.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>Single\u2010center retrospective study of cirrhotic patients included in a prospective cohort admitted to an intensive care unit (ICU) between 2019 and 2022. Inclusion criteria: cirrhosis; overt hepatic encephalopathy; ammonemia \u2265\u00a050\u00a0\u03bcmol\/L. PF considered: gastrointestinal bleeding, infection, acute renal injury (AKI), hyponatremia, constipation, non\u2010adherence to ammonia\u2010lowering therapy, TIPS, drugs precipitating overt hepatic encephalopathy. The primary endpoint was 1\u2010year transplant\u2010free survival (TFS). Secondary endpoint was recurrence of hepatic encephalopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>179\/497 patients were included (men 72%, age 59, cause of cirrhosis alcohol (ALD)\/metALD\/MASLD\/other in 41\/21\/6\/32%, Child\u2013Pugh A\/B\/C in 1\/18\/81%, West Haven grade 2\/3\/4 in 63\/15\/22%, MELD score 23). Reasons for admission were: gastrointestinal bleeding (31%), acute encephalopathy (28%), worsening liver function\/jaundice (25%), infection (8%), and AKI (8%). All patients (100%) had at least one PF of hepatic encephalopathy (infection [64%], AKI [63%], drugs [41%], bleeding [36%], hyponatremia [22%], TIPS [12%], and constipation [1%]), and 82% had multiple concomitant PF. In\u2010hospital mortality was 50%, and median TFS was 0.8\u00a0months. In multivariate analysis, factors associated with death or liver transplantation were the number of PF, MELD and Child\u2013Pugh scores, ACLF, AKI and infection. Hepatic encephalopathy reoccurred in 42% (median delay of 30\u00a0months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>All patients had precipitating factor of hepatic encephalopathy, 82% of them having multiple concomitant precipitating factors. Concomitant multiple precipitating factors were associated with death or liver transplantation. A systematic screening for all precipitating factors of hepatic encephalopathy should be proposed for cirrhotics admitted to intensive care unit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.12706","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T01:04:28Z","timestamp":1741741468000},"page":"738-749","source":"Crossref","is-referenced-by-count":7,"title":["Multiple Concomitant Precipitating Factors of Hepatic Encephalopathy Are Associated With a Poor Prognosis in Patients With Cirrhosis Admitted to Intensive Care Unit"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9155-3345","authenticated-orcid":false,"given":"Marika","family":"Rudler","sequence":"first","affiliation":[{"name":"Liver Intensive Care Unit Hepatogastroenterology Department La Piti\u00e9\u2010Salp\u00eatri\u00e8re Hospital AP\u2010HP Sorbonne Universit\u00e9  Paris France"},{"name":"INSERM UMR_S 938 Centre de recherche 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