Prevalence of and Factors Associated With Minimal Hepatic Encephalopathy in Patients With Cirrhosis of Liver
BACKGROUND/OBJECTIVES: Minimal hepatic encephalopathy (MHE), though highly prevalent, is a frequently underdiagnosed complication of cirrhosis of the liver. Because lack of time is reported as the major reason for non-testing, identifying patients at high risk of MHE would help in targeting them for screening. We aimed to determine the factors associated with MHE to help identify patient subgroups with a higher risk of MHE for targeted screening.
METHODS: Patients with cirrhosis of liver presenting between April 2015 and November 2016 were included. Those with a Psychometric Hepatic Encephalopathy Score (PHES) of ≤-5 points on psychometric testing were diagnosed to have MHE. Various demographic, clinical and laboratory parameters were included in a univariate and later multiple logistic regression models.
RESULTS: Of the 180 (male = 166, 92.2%) patients included 94 (52.2%) had MHE. Though serum albumin, serum total bilirubin, serum aspartate aminotransferase, international normalized ration, Child-Turcotte-Pugh and Model-For-End-Stage-Liver-Disease scores were significant on univariate analysis, only CTP score was found to be significantly associated with MHE (P = 0.002) on multivariate analysis. A higher CTP class was associated with a higher risk of the presence of MHE. The Odds ratio for having MHE was higher with CTP classes of B (P ≤ 0.001) and C (P ≤ 0.001) compared to class A.
CONCLUSIONS: MHE is a common complication in patients with cirrhosis of liver and higher CTP scores independently predict the presence of MHE. Patients with CTP class B and C have a higher risk of suffering from MHE than CTP class A. Screening of patients in CTP class B and C is likely to increase the MHE detection rates while saving time, although select CTP class A patients may also need screening in view of public safety or poor quality of life.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
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| Enthalten in: |
Journal of clinical and experimental hepatology - 8(2018), 2 vom: 01. Juni, Seite 156-161 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bale, Abhijith [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Revised 17.03.2022 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.jceh.2017.06.005 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM285366483 |
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| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM285366483 | ||
| 003 | DE-627 | ||
| 005 | 20231225045305.0 | ||
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| 024 | 7 | |a 10.1016/j.jceh.2017.06.005 |2 doi | |
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| 035 | |a (DE-627)NLM285366483 | ||
| 035 | |a (NLM)29892178 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Bale, Abhijith |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prevalence of and Factors Associated With Minimal Hepatic Encephalopathy in Patients With Cirrhosis of Liver |
| 264 | 1 | |c 2018 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 17.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a BACKGROUND/OBJECTIVES: Minimal hepatic encephalopathy (MHE), though highly prevalent, is a frequently underdiagnosed complication of cirrhosis of the liver. Because lack of time is reported as the major reason for non-testing, identifying patients at high risk of MHE would help in targeting them for screening. We aimed to determine the factors associated with MHE to help identify patient subgroups with a higher risk of MHE for targeted screening | ||
| 520 | |a METHODS: Patients with cirrhosis of liver presenting between April 2015 and November 2016 were included. Those with a Psychometric Hepatic Encephalopathy Score (PHES) of ≤-5 points on psychometric testing were diagnosed to have MHE. Various demographic, clinical and laboratory parameters were included in a univariate and later multiple logistic regression models | ||
| 520 | |a RESULTS: Of the 180 (male = 166, 92.2%) patients included 94 (52.2%) had MHE. Though serum albumin, serum total bilirubin, serum aspartate aminotransferase, international normalized ration, Child-Turcotte-Pugh and Model-For-End-Stage-Liver-Disease scores were significant on univariate analysis, only CTP score was found to be significantly associated with MHE (P = 0.002) on multivariate analysis. A higher CTP class was associated with a higher risk of the presence of MHE. The Odds ratio for having MHE was higher with CTP classes of B (P ≤ 0.001) and C (P ≤ 0.001) compared to class A | ||
| 520 | |a CONCLUSIONS: MHE is a common complication in patients with cirrhosis of liver and higher CTP scores independently predict the presence of MHE. Patients with CTP class B and C have a higher risk of suffering from MHE than CTP class A. Screening of patients in CTP class B and C is likely to increase the MHE detection rates while saving time, although select CTP class A patients may also need screening in view of public safety or poor quality of life | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a AASLD, The American Association for Study of Liver disease | |
| 650 | 4 | |a ALT, alanine transaminase | |
| 650 | 4 | |a AST, aspartate transaminase | |
| 650 | 4 | |a C.I., confidence interval | |
| 650 | 4 | |a CTP, Child Turcotte Pugh | |
| 650 | 4 | |a Child Turcotte Pugh score | |
| 650 | 4 | |a DST, digit symbol test | |
| 650 | 4 | |a FCT, figure connection test | |
| 650 | 4 | |a HE, hepatic encephalopathy | |
| 650 | 4 | |a HRQOL, health-related quality of life | |
| 650 | 4 | |a INR, international normalized ratio | |
| 650 | 4 | |a ISHEN, International Society For Hepatic Encephalopathy and Nitrogen Metabolism | |
| 650 | 4 | |a K+, potassium | |
| 650 | 4 | |a Ltt, line tracing test | |
| 650 | 4 | |a MELD, Model For End-Stage Liver Disease | |
| 650 | 4 | |a MHE, minimal hepatic encephalopathy | |
| 650 | 4 | |a NCT, number connection test | |
| 650 | 4 | |a Na+, sodium | |
| 650 | 4 | |a OR, odds ratio | |
| 650 | 4 | |a PHES, psychometric hepatic encephalopathy score | |
| 650 | 4 | |a Q1,Q3, quartile 1 and quartile 3 | |
| 650 | 4 | |a SD, standard deviation | |
| 650 | 4 | |a SDT, serial dotting test | |
| 650 | 4 | |a SPSS, Statistics Package for Social Sciences | |
| 650 | 4 | |a TIPS, transjugular intrahepatic portosystemic shunt | |
| 650 | 4 | |a WBC, white blood cells | |
| 650 | 4 | |a cirrhosis of liver hepatic encephalopathy | |
| 650 | 4 | |a psychometric hepatic encephalopathy score | |
| 700 | 1 | |a Pai, C Ganesh |e verfasserin |4 aut | |
| 700 | 1 | |a Shetty, Shiran |e verfasserin |4 aut | |
| 700 | 1 | |a Balaraju, Girisha |e verfasserin |4 aut | |
| 700 | 1 | |a Shetty, Anurag |e verfasserin |4 aut | |
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