OBJECTIVE: Hepatic encephalopathy (HE) is a common complication of liver insufficiency. While there is widespread acceptance of its importance, there is no consensus on how best to diagnose and monitor HE. OBJECTIVE: To compare the four most favoured methods for the diagnosis of HE. DESIGN: 170 patients who were on the waiting list for liver transplantation as well as 86 healthy controls were included in the study. All patients and controls underwent the portosystemic encephalopathy syndrome test yielding the psychometric hepatic encephalopathy score (PHES), the repeatable battery for the assessment of neuropsychological status (RBANS), the inhibitory control test (ICT) and critical flicker frequency (CFF) measurement. RESULTS: PHES and ICT targets had the best sensitivity (85.7% vs 85.7%) and specificity (96.5% vs 97.6%) for the diagnosis of overt HE. CFF showed inferior sensitivity (40.9%) for the diagnosis of HE and dependency from previous alcohol abuse (p=0.015). Multiple regression analysis showed that all test results apart from PHES were influenced by secondary diagnoses such as diabetes mellitus and renal insufficiency. CONCLUSIONS: In the German population of patients awaiting liver transplantation, PHES is the most robust method for the diagnosis and follow-up of HE.
OBJECTIVE:Hepatic encephalopathy (HE) is a common complication of liver insufficiency. While there is widespread acceptance of its importance, there is no consensus on how best to diagnose and monitor HE. OBJECTIVE: To compare the four most favoured methods for the diagnosis of HE. DESIGN: 170 patients who were on the waiting list for liver transplantation as well as 86 healthy controls were included in the study. All patients and controls underwent the portosystemic encephalopathy syndrome test yielding the psychometric hepatic encephalopathy score (PHES), the repeatable battery for the assessment of neuropsychological status (RBANS), the inhibitory control test (ICT) and critical flicker frequency (CFF) measurement. RESULTS:PHES and ICT targets had the best sensitivity (85.7% vs 85.7%) and specificity (96.5% vs 97.6%) for the diagnosis of overt HE. CFF showed inferior sensitivity (40.9%) for the diagnosis of HE and dependency from previous alcohol abuse (p=0.015). Multiple regression analysis showed that all test results apart from PHES were influenced by secondary diagnoses such as diabetes mellitus and renal insufficiency. CONCLUSIONS: In the German population of patients awaiting liver transplantation, PHES is the most robust method for the diagnosis and follow-up of HE.
Authors: Kevin Duff; Dana McDermott; Dan Luong; Christopher Randolph; Adam L Boxer Journal: J Clin Exp Neuropsychol Date: 2019-02-04 Impact factor: 2.475
Authors: M M Lauridsen; L Poulsen; C K Rasmussen; M Høgild; M K Nielsen; O B Schaffalitzky de Muckadell; H Vilstrup Journal: Metab Brain Dis Date: 2015-10-05 Impact factor: 3.584
Authors: Jasmohan S Bajaj; Andrew Fagan; Melanie B White; James B Wade; Phillip B Hylemon; Douglas M Heuman; Michael Fuchs; Binu V John; Chathur Acharya; Masoumeh Sikaroodi; Patrick M Gillevet Journal: Am J Gastroenterol Date: 2019-07 Impact factor: 10.864
Authors: Elliot B Tapper; Neehar D Parikh; Akbar K Waljee; Michael Volk; Noelle E Carlozzi; Anna S-F Lok Journal: Am J Gastroenterol Date: 2018-03-13 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