Prevalence of Covert Hepatic Encephalopathy in A Tertiary Care Centre

Abstract

Introduction: Among patients with Hepatic Encephalopathy, prevalence of Minimal HE variesbetween 30-50%. Identifying patients with MHE has been shown to improve with medications anddelay development of Overt HE, however only limited clinicians screen for MHE in patients due totime consuming neuropsychological and neurophysiological tests. The Number Connection Test isan easy way to evaluate patients to diagnose MHE. The aim of this study is to find out the prevalenceof covert hepatic encephalopathy.
 Methods: The descriptive cross-sectional study was done to find out the prevalence of covert hepaticencephalopathy among patients with chronic liver disease. To diagnose Covert HE which includedMHE as well, NCT was used in Devanagari script.
 Results: The prevalence of covert hepatic encephalopathy is found to be 56 (58.3%) at 90% confidenceinterval (58.23-58.37%). A total of 96 patients (71.9% male) were diagnosed as HE, with mean age of49.6+11.8 years. The cause of CLD in 85 (88.5%) of these patients was alcohol, of which 76 (79.2%)consumed locally brewed alcohol. Of these 96 patients with HE, only 40 (41.7%) had overt HE.Among all these, maximum patients had MHE (37.5%).
 Conclusions: Our study showed that although the prevalence of minimal HE is quite high amongcirrhotics, they are usually missed in clinical practice due to absence of symptoms. Active screeningwith easy-to-administer tests, like Number Connection tests, can help identify patients with minimalHE and hence treat them early.

Hepatic Encephalopathy among Patients with Chronic Liver Disease Admitted to the Department of Internal Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…In contrast to our finding, another similar study showed covert HE was more common than overt HE with a prevalence of 58.30% and 41.70% respectively. 7 According to our study, the prevalence of overt HE and covert HE among CLD patients is 5.91% and 4.37% respectively. On the contrary, western studies have shown that Overt HE is seen in 30%-45% of cirrhotic patients.…”

“…In contrast to our finding, another similar study showed covert HE was more common than overt HE with a prevalence of 58.30% and 41.70% respectively. 7 …”