On the multivariate analysis, age [odds ratio (OR) = 1.07, 95% CI: 1.03–1.12, p = 0.001], albumin (OR = 1.13, 95% CI: 1.04–1.24, p = 0.006), history of previous HE (OR = 242.52, 95% CI: 40.17–1464.11, p < 0.001) and the CLIF-SOFA score (OR =2.89, 95% CI: 2.11–3.96, p < 0.001) were significantly associated with the risk of developing HE in decompensated cirrhosis patients during hospitalization (Table 3). This evidence concerns the gene ALB and hereditary elliptocytosis.