Multivariable analysis revealed that serum albumin (sub-distribution hazard ratio [SHR], 0.51; 95% confidence interval [CI], 0.27–0.98; p = 0.042) and ammonia (SHR, 1.01; 95% CI, 1.00–1.02; p = 0.006) levels were independent factors for OHE development in geriatric cirrhosis. The gene discussed is ALB; the disease is Cirrhosis.