The Predicting Value Of A Simplified Psychometric Hepatic Encephalopathy Score For Overt Hepatic Encephalopathy

Objective Minimal hepatic encephalopathy(MHE)patients have no recognizable clinical symptoms of HE,which usually have a normal mental and neurological status upon routine clinical examination.MHE is also a risk factor for the development of overt hepatic encephalopathy(OHE).We investigated whether a simplified psychometric hepatic encephalopathy score(SPHES)is useful for predicting the occurrence of OHE.Methods We measured in 150 controls and 150 hepatitis B cirrhotic patients without OHE from January 2015 to March 2016,who were followed up for the development of OHE.The psychometric hepatic encephalopathy scale(PHES)is used as a standard for diagnotic of MHE.Results 62 patients of 150 cirrhotic patients are diagnosed as MHE when we used PHES as a standard.53 patients of 150 cirrhotic patients are diagnosed as MHE when we used SPHES as a standard.There are no significant differences(P=0.342),36 of the 150 patients developed OHE who were followed up for 24 months,27/29 patients 0f MHE based on PHES/SPHES developed OHE.The likelihood of developing OHE was higher among patients with an abnormal PHES(log-rank P<0.01)or SPHES(log-rank P<0.01).By using Cox regression to analyze data from patients with previous HE and transjugular intrahepatic portosystemic shunts,PHES(P<0.01)and SPHES(P<0.01)were the only variables associated with the development of OHE.The receiver operating characteristic(ROC)curve analysis of PHES/SPHES for the prediction of OHE showed an area under the curve(AUC)value of 0.798/0.703(95% confidence interval 0.93 – 0.99).Conclusion SPHES is useful for predicting the occurrence of OHE,which consumes less time and is more suitable for clinical screening.