Ventura-Cots, MeritxellCarmona, IsabelMoreno, CarolinaAmpuero, JavierSimón-Talero, MacarenaSanpedro, FrancescLes, IñigoRomero-Gómez, ManuelGenescà, Joan2025-01-072025-01-072017-11-261756-283Xhttps://hdl.handle.net/10668/26565Episodes of hepatic encephalopathy (HE) have been related to low survival rate. However, the relation between its clinical evolution and mortality has not been assessed. A retrospective analysis of 245 cirrhotic patients admitted for an acute episode of HE (⩾grade 2) or who developed an HE episode after an upper gastrointestinal bleeding (UGIB) event was performed to assess the relation between time in HE and transplant-free survival. Median (IQR25-75) time in HE was 48 h (24-96 h) in the whole cohort. Patients who presented a longer time in HE (>48 h; n = 89) exhibited a lower transplant-free survival at 28 days (67.2% versus 88.9%, p 48 h; n = 89) exhibited a lower transplant-free survival at 28 days (67.2% versus 88.9%, p 48 h, when comparing patients according to baseline HE grade (2 versus ⩾3) or model for end-stage liver disease (MELD) function (⩽15 versus >15). Time in HE was also an independent risk factor for mortality at each time point, hazard ratio (HR) (95 CI%) 28 days 2.59 (1.39-4.84); 90 days 1.98 (1.28-3.1) and 365 days 1.5 (1.08-2.19). The duration of the acute HE episode determines survival in cirrhotic patients independently of liver function and baseline HE grade.enAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/hepatic encephalopathytime in hepatic encephalopathytransplant-free survivalresearch article29383024open access10.1177/1756283X17743419PMC5784576https://journals.sagepub.com/doi/pdf/10.1177/1756283X17743419https://pmc.ncbi.nlm.nih.gov/articles/PMC5784576/pdf