Detection of Minimal Hepatic Encephalopathy in Iranian Patients with Cirrhosis

Abstract

BACKGROUND Minimal hepatic encephalopathy (MHE) is the mildest type of hepatic encephalopathy in patients with cirrhosis. Patients with MHE have normal clinical and physical examination but they show some neurocognitive dysfunctions that affect their quality of life negatively. The aim of the current study is to diagnose MHE in patients with cirrhosis and its associated factors. METHODS This is a cross-sectional study on 120 known cases of cirrhosis referred to hospitals affiliated to Isfahan University of Medical Sciences during 2014-17. The patients’ cirrhosis severity was evaluated using laboratory tests and physical examinations based on MELD (Model for End-stage Liver Disease) and Child-Pugh criteria. The patients’ demographics were filled in a checklist. All included patients with cirrhosis were asked to respond to the questions of Psychometric Hepatic Encephalopathy Score (PHES) test. RESULTS Mean age of the patients was 51.2 ± 9.7 years. 62 (51.7%) patients were men and 58 (48.3%) patients were women. The mean score of the patients based on MELD criteria was 14.03 ± 6.09. 26.7% of the patients presented MHE. Mean age of the patients with MHE was statistically less than the patients without MHE (p value < 0.001). Mean score of MELD criteria among the patients with diagnosis of MHE was significantly higher than the other group (p value < 0.001). The patients’ Child class was statistically associated with MHE (p value < 0.001). Men were significantly more affected than women (p value = 0.03). CONCLUSION MHE was associated with MELD score and Child class of the patients with cirrhosis. The noticeable point was reversible association of age with MHE. Further studies are recommended.

Artificial Intelligence and Its Application to Minimal Hepatic Encephalopathy Diagnosis

“…Patients with liver cirrhosis and with no clinical manifestation of HE are diagnosed with MHE if they achieve a total score of less than −4 [18]. PHES has been adapted in many different countries (China, India, Italy, Iran, Korea, Mexico, Poland, Portugal, Romania, Spain, and Turkey) [19][20][21][22][23][24][25][26][27][28][29]. The PHES battery of 5 tests is currently considered to be the best clinical standard for the diagnosis of MHE [25].…”