<b>Frequency of Hepatic Encephalopathy in Patients with Chronic Liver Disease Presented to the Emergency Ward</b>

Background: Hepatic encephalopathy is a clinically important neuropsychiatric complication of chronic liver disease and is frequently associated with emergency presentation, repeated hospitalization, functional impairment, and increased mortality. Objective: To determine the frequency of hepatic encephalopathy among patients with chronic liver disease presenting to the emergency ward and to describe its association with selected demographic and clinical characteristics. Methods: This prospective observational study was conducted in the Department of Emergency Medicine, Lady Reading Hospital–Medical Teaching Institution, Peshawar, from September 2025 to February 2026. A total of 150 adult patients with chronic liver disease were enrolled using non-probability consecutive sampling. Chronic liver disease was diagnosed using clinical, laboratory, and radiological criteria. Hepatic encephalopathy was assessed clinically and graded according to West Haven criteria. Data were analyzed using SPSS version 26, with categorical variables expressed as frequencies and percentages and quantitative variables summarized as mean ± standard deviation. Results: The mean age of patients was 51.84 ± 12.63 years, and 92 patients (61.3%) were male. Hepatic encephalopathy was present in 49 patients, giving a frequency of 32.7%. Grade II hepatic encephalopathy was the most common presentation, accounting for 38.8% of affected cases. Hepatitis C virus infection was the leading etiology of chronic liver disease. Increasing age and longer duration of chronic liver disease showed significant associations with hepatic encephalopathy. Conclusion: Hepatic encephalopathy was a frequent complication among patients with chronic liver disease presenting to emergency care, affecting nearly one-third of the study population. Early recognition, standardized grading, and timely management may help reduce disease-related morbidity and adverse outcomes.