Serum Ammonia Levels and Overt Hepatic Encephalopathy in Hospitalized Patients with Cirrhosis

Some clinicians routinely order serum ammonia testing for patients with overt hepatic encephalopathy (OHE), but evidence does not support this practice. In this secondary analysis of data from a rifaximin treatment trial (Clin Gastroenterol Hepatol 2023; 21:723), researchers assessed the correlation between serum ammonia levels on hospital day 1 and clinical features of hepatic encephalopathy and liver disease among hospitalized adults with cirrhosis and OHE.

Among 44 patients with baseline ammonia levels available, the median level on the first hospital day was 86 μg/dL. No correlation was observed between serum ammonia levels and initial Hepatic Encephalopathy Grading Instrument grade, initial Model for End-Stage Liver Disease (MELD) score…