group were significantly higher than cirrhosis group (q = 10.59, p ≤ 0.001). In all 3 groups, an increase in mean serum ammonia levels were associated with worsening clinical status. Out of 84 patients, 12 patients (14.29%) of cirrhosis group, 18 (21.43%) of acute viral hepatitis group, 4 (4.76%) of drug induced hepatitis expired during the course of illness. A higher risk of mortality was observed with an increase in serum ammonia levels. In cirrhosis group, 100% mortality was found with serum ammonia > 200 µg/dL. In acute viral hepatitis, 70% mortality was observed with serum ammonia levels > 200µg/dL. In drug induced hepatitis, 100% mortality was observed with serum ammonia values > 150 µg/dL. CONCLUSION: An elevated serum ammonia level is an important laboratory abnormality in patients with HE. Both the mortality and severity of HE increases with an increase in serum ammonia levels. This could be useful in identifying patientswith higher grades of HE, suggesting that estimation of serum ammonia could be a useful tool in assessing the severity of illness and to plan for aggressive detoxification measures. ABSTRACT AIM: To study serum ammonia levels and its correlation with clinical status in patients of hepatic encephalopathy.
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