Prevalence of and Factors Associated With Minimal Hepatic Encephalopathy in Patients With Cirrhosis of Liver

Bale, Abhijith and Pai, Ganesh C and Shetty, Shiran and Balaraju, Girisha and Shetty, Anurag J (2018) Prevalence of and Factors Associated With Minimal Hepatic Encephalopathy in Patients With Cirrhosis of Liver. Journal of Clinica land Experimental Hepatology, 8 (2). pp. 156-161. ISSN 0973-6883

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Abstract

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 nontesting, 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 (P0.001) and C (P0.001) 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.

Item Type: Article
Uncontrolled Keywords: Child Turcotte Pugh score; Cirrhosis of liver hepatic encephalopathy; Psychometric hepatic encephalopathy score
Subjects: Medicine > KMC Manipal > Gastroenterology
Depositing User: KMC Library
Date Deposited: 10 Sep 2018 06:09
Last Modified: 10 Sep 2018 06:09
URI: http://eprints.manipal.edu/id/eprint/151947

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