A prolonged activated partial thromboplastin time indicates poor short-term prognosis in patients with hepatic encephalopathy: Insights from the MINIC Database

Liping Zhan ¹ Du Shenshen ² Yuping Yang ¹ Biao Nie ¹ Yuan Tian ³ Yujie Huang ¹ Ruyin Ye ¹ Yanqi Kou ⁴ Zhe Huang ¹ Botao Luo ³ Lei Ge ¹ Shicai Ye ^1*

• ¹ Affiliated Hospital of Guangdong Medical College Hospital, Zhanjiang, Guangdong Province, China
• ² Huanghe Sanmenxia Hospital, Sanmenxia, Henan Province, China
• ³ Guangdong Medical University, Zhanjiang, China
• ⁴ The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan Province, China

Objectives: This study investigates serum markers for short-term prognosis in hepatic encephalopathy patients.Background: 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.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-Meier analysis and Cox regression models to examine associations between groups and outcomes.Results: Upon comparing baseline characteristics, the high APTT group exhibited significant disparities in acute kidney injury, sepsis, coagulation disorders, and ascites (p < 0.05). 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, p = 0.033) and 1.010 (1.002,1.018, p = 0.013), 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-Meier survival curves from these groups demonstrated a lower survival probability for patients in the high APTT group than the normal group (log-rank p < 0.05). The results of subgroup analysis and interaction analysis indicate that APTT is not influenced by other confounding factors.A prolonged APTT suggests a poorer short-term prognosis in patients with hepatic encephalopathy. Keyword：hepatic encephalopathy，APTT，prognosis.