BACKGROUND: Hepatic encephalopathy (HE) is a common cause of hospital admission in patients with cirrhosis involving high costs of care. AIM: To evaluate the use of L-ornithine L-aspartate (LOLA) vs. lactulose is able to reduce the length of hospital stay and the timing of improvement of hepatic encephalopathy. METHODS: Retrospective and comparative study of patients with HE admitted to the Medical Gastroenterology Unit of a tertiary referral center in Mexico City (Hospital General de México) in a period of three years. Patients were divided in two treatment groups: LOLA vs. oral lactulose. We compared time to remission of encephalopathy, days of hospital stay and costs of hospital care. RESULTS: We included 80 patients: 40 patients who received treatment with latulose had acumulative hospital stay of 443 days vs. 264 days for those who received LOLA (40% reduction in hospital stay). In the group treated with lactulose, mean hospital stay was 11.07 days vs. 6.47 days in the group treated with LOLA. Thus, a significantly greater number of patients treated with LOLA remained hospitalized less than a week compared with those treated with lactulose (65% vs. 20% respectively. OR 4.33, 95% CI 1.67- 11.23, p = 0.004). The mean recovery time of encephalopathy was less with LOLA treatment (4.32 vs. 10.15 days). CONCLUSION: Treatment with LOLA was more effective in improving HE and reducing the duration of hospital stay.
BACKGROUND:Hepatic encephalopathy (HE) is a common cause of hospital admission in patients with cirrhosis involving high costs of care. AIM: To evaluate the use of L-ornithine L-aspartate (LOLA) vs. lactulose is able to reduce the length of hospital stay and the timing of improvement of hepatic encephalopathy. METHODS: Retrospective and comparative study of patients with HE admitted to the Medical Gastroenterology Unit of a tertiary referral center in Mexico City (Hospital General de México) in a period of three years. Patients were divided in two treatment groups: LOLA vs. oral lactulose. We compared time to remission of encephalopathy, days of hospital stay and costs of hospital care. RESULTS: We included 80 patients: 40 patients who received treatment with latulose had acumulative hospital stay of 443 days vs. 264 days for those who received LOLA (40% reduction in hospital stay). In the group treated with lactulose, mean hospital stay was 11.07 days vs. 6.47 days in the group treated with LOLA. Thus, a significantly greater number of patients treated with LOLA remained hospitalized less than a week compared with those treated with lactulose (65% vs. 20% respectively. OR 4.33, 95% CI 1.67- 11.23, p = 0.004). The mean recovery time of encephalopathy was less with LOLA treatment (4.32 vs. 10.15 days). CONCLUSION: Treatment with LOLA was more effective in improving HE and reducing the duration of hospital stay.
Authors: Ee Teng Goh; Caroline S Stokes; Sandeep S Sidhu; Hendrik Vilstrup; Lise Lotte Gluud; Marsha Y Morgan Journal: Cochrane Database Syst Rev Date: 2018-05-15