BACKGROUND & AIMS: The psychometric hepatic encephalopathy score (PHES), which includes 5 psychometric tests, is a standard for the diagnosis of minimal hepatic encephalopathy (HE). We investigated whether a simplified PHES (SPHES) is as useful as the whole PHES. METHODS: The PHES was determined for 79 cirrhotic patients (the training group), who were followed up for the development of overt HE. Backward logistic regression was performed by eliminating stepwise variables--removal did not impair regression. A separate series of 65 patients was used as a validation group. RESULTS: The PHES was abnormal in 45 patients. The SPHES, determined from the digit symbol, serial dotting, and line tracing tests, did not differ significantly from the full PHES; 24 of the 79 patients developed overt HE. The likelihood of developing overt HE was higher among patients with an abnormal PHES (log-rank P = .003) or SPHES (P = .004). By using Cox regression and model for end-stage liver disease scores to analyze data from patients with previous HE and transjugular intrahepatic portosystemic shunts, PHES (relative risk, 4.16; P = .003) and SPHES (relative risk, 3.70; P = .004) were the only variables associated with the development of overt HE. The accuracy of the SPHES was confirmed in the validation group. CONCLUSIONS: A simplified PHES is as good as the PHES in diagnosing minimal HE and in predicting the occurrence of overt HE.
BACKGROUND & AIMS: The psychometric hepatic encephalopathy score (PHES), which includes 5 psychometric tests, is a standard for the diagnosis of minimal hepatic encephalopathy (HE). We investigated whether a simplified PHES (SPHES) is as useful as the whole PHES. METHODS: The PHES was determined for 79 cirrhotic patients (the training group), who were followed up for the development of overt HE. Backward logistic regression was performed by eliminating stepwise variables--removal did not impair regression. A separate series of 65 patients was used as a validation group. RESULTS: The PHES was abnormal in 45 patients. The SPHES, determined from the digit symbol, serial dotting, and line tracing tests, did not differ significantly from the full PHES; 24 of the 79 patients developed overt HE. The likelihood of developing overt HE was higher among patients with an abnormal PHES (log-rank P = .003) or SPHES (P = .004). By using Cox regression and model for end-stage liver disease scores to analyze data from patients with previous HE and transjugular intrahepatic portosystemic shunts, PHES (relative risk, 4.16; P = .003) and SPHES (relative risk, 3.70; P = .004) were the only variables associated with the development of overt HE. The accuracy of the SPHES was confirmed in the validation group. CONCLUSIONS: A simplified PHES is as good as the PHES in diagnosing minimal HE and in predicting the occurrence of overt HE.
Authors: Chathur Acharya; Jawaid Shaw; Nikki Duong; Andrew Fagan; Sara McGeorge; James B Wade; Leroy R Thacker; Jasmohan S Bajaj Journal: Clin Gastroenterol Hepatol Date: 2022-01-06 Impact factor: 13.576
Authors: Kavish R Patidar; Leroy R Thacker; James B Wade; Richard K Sterling; Arun J Sanyal; Mohammad S Siddiqui; Scott C Matherly; R Todd Stravitz; Puneet Puri; Velimir A Luketic; Michael Fuchs; Melanie B White; Nicole A Noble; Ariel B Unser; HoChong Gilles; Douglas M Heuman; Jasmohan S Bajaj Journal: Am J Gastroenterol Date: 2014-09-02 Impact factor: 10.864
Authors: Marsha Y Morgan; Piero Amodio; Nicola A Cook; Clive D Jackson; Gerald Kircheis; Mette M Lauridsen; Sara Montagnese; Sami Schiff; Karin Weissenborn Journal: Metab Brain Dis Date: 2015-09-28 Impact factor: 3.584