Clinical Predictors for Poor Quality of Life in Patients With Covert Hepatic Encephalopathy. Issue 7 (August 2019)

• Record Type: Journal Article
• Authors: Labenz, Christian; Toenges, Gerrit; Schattenberg, Jörn M.; Nagel, Michael; Sprinzl, Martin F.; Nguyen-Tat, Marc; Zimmermann, Tim; Huber, Yvonne; Marquardt, Jens U.; Galle, Peter R.; Wörns, Marcus-Alexander
• Is Part Of: Journal of clinical gastroenterology. Volume 53:Issue 7(2019)
• Publication Date: 2019-08
• Subjects: covert hepatic encephalopathy -- hepatic encephalopathy grade 1 -- minimal hepatic encephalopathy -- health-related quality of life; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Digestive organs -- Diseases; Gastroenterology; Periodicals; Periodicals; 616.33005
• DOI: 10.1097/MCG.0000000000001149
• Languages: English
• ISSNs: 0192-0790

Abstract

Abstract : Background: Current EASL/AASLD guidelines recommend treatment of covert hepatic encephalopathy (HE) only in symptomatic patients, for example, in those with impaired quality of life or with affected driving abilities. Goals: Because testing for impaired quality of life is time consuming, the aim of the present study was to identify simple clinical predictors for poor quality of life in patients with covert HE (CHE). Study: In total, 139 cirrhotic in- and outpatients without a history of overt hepatic encephalopathy were enrolled. Diagnosis of HE grade 1 (HE1) was diagnosed clinically according to the West-Haven Criteria. Critical flicker frequency and the Psychometric Hepatic Encephalopathy Score were used to detect minimal HE (MHE). Chronic Liver Disease Questionnaire was used to assess health-related quality of life (HrQoL). Results: CHE was detected in 51 (36.7%) patients. Multivariate analysis identified a history of falls in the previous year ( P =0.003) and female gender ( P =0.030) as independent predictors of reduced HRQoL in patients with CHE. Comparison of patients with and without a history of falls revealed relevant differences in the subdomains—abdominal symptoms, fatigue, systemic symptoms, emotional functions and worries. Conclusions: A history of falls and female gender are associated with impaired HRQoL in patients with CHE. These data indicate that a history of falls should be considered as a treatment indication in patients with CHE to improve HRQoL and ultimately prognosis.