BACKGROUND: It has been observed that overt hepatic encephalopathy (HE) is accompanied by a persistent cognitive defect, suggesting that HE may not be fully reversible. The health-related quality-of-life (HRQoL) has been shown to be impaired by cirrhosis, and, according to some reports, influenced by minimal HE. Little is known about the effect of previous HE on HRQoL. AIM: To investigate the relative impact of previous HE and minimal HE on HRQoL in a group of consecutively hospitalized cirrhotic patients. PATIENTS/ METHODS: Seventy five consecutive cirrhotic patients were evaluated using the Psychometric HE Score (PHES) and simplified Psychometric HE Score (SPHES) to detect the presence of minimal HE and using SF-36 to assess the HRQoL, both corrected for age and education. Eighteen of them had previous bouts of overt HE. RESULTS: Minimal HE was significantly more frequent in patients with previous HE than in those without (p < 0.001), independently on the method used for the diagnosis (PHES or SPHES). A deeper impairment in several domains of SF-36 was observed in patients with previous bouts of overt HE, in those with ascites, as well as in those with decompensated cirrhosis. At multivariate analysis, ascites, MELD score and previous HE were independently related to the mental-component-summary (MCS) of SF-36, whereas ascites was the only variable independently associated with the physical-component-summary (PCS) of SF-36. Minimal HE (independently on the method used for its diagnosis) impaired only one domain of SF-36. CONCLUSIONS: These data suggest that previous bouts of HE, despite their complete clinical resolution, play an independent role in producing a persistent impairment in HRQoL of cirrhotics.
BACKGROUND: It has been observed that overt hepatic encephalopathy (HE) is accompanied by a persistent cognitive defect, suggesting that HE may not be fully reversible. The health-related quality-of-life (HRQoL) has been shown to be impaired by cirrhosis, and, according to some reports, influenced by minimal HE. Little is known about the effect of previous HE on HRQoL. AIM: To investigate the relative impact of previous HE and minimal HE on HRQoL in a group of consecutively hospitalized cirrhotic patients. PATIENTS/ METHODS: Seventy five consecutive cirrhotic patients were evaluated using the Psychometric HE Score (PHES) and simplified Psychometric HE Score (SPHES) to detect the presence of minimal HE and using SF-36 to assess the HRQoL, both corrected for age and education. Eighteen of them had previous bouts of overt HE. RESULTS: Minimal HE was significantly more frequent in patients with previous HE than in those without (p < 0.001), independently on the method used for the diagnosis (PHES or SPHES). A deeper impairment in several domains of SF-36 was observed in patients with previous bouts of overt HE, in those with ascites, as well as in those with decompensated cirrhosis. At multivariate analysis, ascites, MELD score and previous HE were independently related to the mental-component-summary (MCS) of SF-36, whereas ascites was the only variable independently associated with the physical-component-summary (PCS) of SF-36. Minimal HE (independently on the method used for its diagnosis) impaired only one domain of SF-36. CONCLUSIONS: These data suggest that previous bouts of HE, despite their complete clinical resolution, play an independent role in producing a persistent impairment in HRQoL of cirrhotics.
Authors: Silvia Nardelli; Sanath Allampati; Oliviero Riggio; Kevin D Mullen; Ravi Prakash; Stefania Gioia; Ariel Unser; Melanie B White; Andrew C Fagan; James B Wade; Alessio Farcomeni; Edith A Gavis; Jasmohan S Bajaj Journal: Dig Dis Sci Date: 2016-12-30 Impact factor: 3.199
Authors: Katherine C Barboza; Lilian M Salinas; Farhad Sahebjam; Arun B Jesudian; Ilan L Weisberg; Samuel H Sigal Journal: Metab Brain Dis Date: 2016-03-31 Impact factor: 3.584
Authors: Vishwadeep Ahluwalia; James B Wade; Leroy Thacker; Kenneth A Kraft; Richard K Sterling; R Todd Stravitz; Michael Fuchs; Iliana Bouneva; Puneet Puri; Velimir Luketic; Arun J Sanyal; Hochong Gilles; Douglas M Heuman; Jasmohan S Bajaj Journal: J Hepatol Date: 2013-05-07 Impact factor: 25.083