{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T01:05:10Z","timestamp":1773968710477,"version":"3.50.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study investigates serum markers for short-term prognosis in hepatic encephalopathy patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with hepatic encephalopathy face elevated mortality rates and bleak prognoses. However, effective prognostic models or indicators are lacking. This study aims to explore serum markers for predicting short-term prognosis in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective analysis of 552 patients with hepatic encephalopathy, categorizing 429 individuals meeting exclusion criteria into normal and high activated partial thromboplastin time (APTT) groups. We assessed 12-day and 25-day survival rates using Kaplan\u2013Meier analysis and Cox regression models to examine associations between groups and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Upon comparing baseline characteristics, the high APTT group exhibited significant disparities in acute kidney injury, sepsis, coagulation disorders, and ascites (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). In the multivariate COX regression model, the hazard ratios [HRs; 95% confidence interval (CI)] of 12- and 25-day mortality were 1.012 (1.001, 1.022, <jats:italic>p<\/jats:italic>\u202f=\u202f0.033) and 1.010 (1.002, 1.018, <jats:italic>p<\/jats:italic>\u202f=\u202f0.013), respectively. We discovered that APTT demonstrated an independent association with prognosis. Our findings revealed that the ability of APTT to predict short-term prognosis surpasses that of the traditional MELD model. Regarding 12- and 25-day survival, Kaplan\u2013Meier survival curves from these groups demonstrated a lower survival probability for patients in the high APTT group than the normal group (log-rank <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). The results of subgroup analysis and interaction analysis indicate that APTT is not influenced by other confounding factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A prolonged APTT suggests a poorer short-term prognosis in patients with hepatic encephalopathy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1514327","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T07:10:06Z","timestamp":1739430606000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["A prolonged activated partial thromboplastin time indicates poor short-term prognosis in patients with hepatic encephalopathy: insights from the MIMIC database"],"prefix":"10.3389","volume":"12","author":[{"given":"Liping","family":"Zhan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuping","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biao","family":"Nie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanqi","family":"Kou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shenshen","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Tian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yujie","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruyin","family":"Ye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhe","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Botao","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Ge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shicai","family":"Ye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.cld.2020.01.001","article-title":"Epidemiology of hepatic encephalopathy","volume":"24","author":"Elsaid","year":"2020","journal-title":"Clin Liver Dis"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1002\/hep.29887","article-title":"The high burden of alcoholic cirrhosis in privately insured persons in the United States","volume":"68","author":"Mellinger","year":"2018","journal-title":"Hepatology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1526","DOI":"10.1016\/j.jhep.2020.07.013","article-title":"Hepatic encephalopathy: novel insights into classification, pathophysiology and therapy","volume":"73","author":"Rose","year":"2020","journal-title":"J Hepatol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"5623601","DOI":"10.1155\/2021\/5623601","article-title":"Prediction and risk factors for prognosis of cirrhotic patients with hepatic encephalopathy","volume":"2021","author":"Peng","year":"2021","journal-title":"Gastroenterol Res Pract"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1002\/hep.30533","article-title":"Predicting overt hepatic encephalopathy for the population with cirrhosis","volume":"70","author":"Tapper","year":"2019","journal-title":"Hepatology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/j.cld.2021.01.008","article-title":"Diagnosis and management of hepatic encephalopathy","volume":"25","author":"Rudler","year":"2021","journal-title":"Clin Liver Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1646","DOI":"10.1038\/ajg.2011.157","article-title":"The multi-dimensional burden of cirrhosis and hepatic encephalopathy on patients and caregivers","volume":"106","author":"Bajaj","year":"2011","journal-title":"Am J Gastroenterol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1111\/liv.13752","article-title":"Hepatic encephalopathy: diagnosis and management","volume":"38","author":"Amodio","year":"2018","journal-title":"Liver Int"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1660","DOI":"10.1056\/NEJMra1600561","article-title":"Hepatic encephalopathy","volume":"375","author":"Wijdicks","year":"2016","journal-title":"N Engl J Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1007\/s00535-021-01788-x","article-title":"Evidence-based clinical practice guidelines for liver cirrhosis 2020","volume":"56","author":"Yoshiji","year":"2021","journal-title":"J Gastroenterol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1053\/j.gastro.2019.03.070","article-title":"AGA clinical practice update: coagulation in cirrhosis","volume":"157","author":"O\u2019Leary","year":"2019","journal-title":"Gastroenterology"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1055\/s-0038-1673658","article-title":"Coagulation pathways, hemostasis, and thrombosis in liver failure","volume":"39","author":"Intagliata","year":"2018","journal-title":"Semin Respir Crit Care Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1097\/MOG.0000000000000635","article-title":"Coagulation testing and management in liver disease patients","volume":"36","author":"Stotts","year":"2020","journal-title":"Curr Opin Gastroenterol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1111\/jgh.14408","article-title":"Mechanistic insight, diagnosis, and treatment of ammonia-induced hepatic encephalopathy","volume":"34","author":"Fiati Kenston","year":"2019","journal-title":"J Gastroenterol Hepatol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1038\/s41575-018-0097-3","article-title":"Hepatic microcirculation and mechanisms of portal hypertension","volume":"16","author":"Gracia-Sancho","year":"2019","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"8999","DOI":"10.3390\/ijms23168999","article-title":"The link between gut microbiota and hepatic encephalopathy","volume":"23","author":"Won","year":"2022","journal-title":"Int J Mol Sci"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41597-022-01899-x","article-title":"MIMIC-IV, a freely accessible electronic health record dataset","volume":"10","author":"Johnson","year":"2023","journal-title":"Sci Data"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/s40779-021-00338-z","article-title":"Data mining in clinical big data: the frequently used databases, steps, and methodological models","volume":"8","author":"Wu","year":"2021","journal-title":"Mil Med Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"114696","DOI":"10.1016\/j.ab.2022.114696","article-title":"Amino acids, ammonia, and hepatic encephalopathy","volume":"649","author":"Kroupina","year":"2022","journal-title":"Anal Biochem"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1615","DOI":"10.1053\/j.gastro.2021.08.015","article-title":"AGA clinical practice guideline on the management of coagulation disorders in patients with cirrhosis","volume":"161","author":"O\u2019Shea","year":"2021","journal-title":"Gastroenterology"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1016\/j.jhep.2021.09.003","article-title":"EASL clinical practice guidelines on prevention and management of bleeding and thrombosis in patients with cirrhosis","volume":"76","year":"2022","journal-title":"J Hepatol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1630","DOI":"10.1053\/j.gastro.2021.09.004","article-title":"AGA technical review on coagulation in cirrhosis","volume":"161","author":"Intagliata","year":"2021","journal-title":"Gastroenterology"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"S358","DOI":"10.1016\/S0168-8278(22)01072-8","article-title":"Increased platelet aggregation in patients with decompensated cirrhosis indicates higher risk of further decompensation and death","volume":"77","author":"Zanetto","year":"2022","journal-title":"J Hepatol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"100733","DOI":"10.1016\/j.blre.2020.100733","article-title":"Interplay between platelets and coagulation","volume":"46","author":"Sang","year":"2021","journal-title":"Blood Rev"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"083","DOI":"10.1055\/s-2002-23205","article-title":"Coagulation disorders in liver disease","volume":"22","author":"Amitrano","year":"2002","journal-title":"Semin Liver Dis"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s40265-018-1018-z","article-title":"Hepatic encephalopathy: definition, clinical grading and diagnostic principles","volume":"79","author":"Weissenborn","year":"2019","journal-title":"Drugs"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"2325","DOI":"10.1002\/hep.30103","article-title":"Coagulation failure in patients with acute-on-chronic liver failure and decompensated cirrhosis: beyond the international normalized ratio","volume":"68","author":"Blasi","year":"2018","journal-title":"Hepatology"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1514327\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T07:10:08Z","timestamp":1739430608000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1514327\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,13]]},"references-count":27,"alternative-id":["10.3389\/fmed.2025.1514327"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1514327","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,13]]},"article-number":"1514327"}}