The prognostic significance of subclinical hepatic encephalopathy

Am J Gastroenterol. 2000 Aug;95(8):2029-34. doi: 10.1111/j.1572-0241.2000.02265.x.

Abstract

Objective: Subclinical hepatic encephalopathy may have prognostic significance with regard to the development of clinical hepatic encephalopathy and survival.

Methods: We studied 116 consecutive patients with histologically proven cirrhosis of the liver for subclinical hepatic encephalopathy, using Number Connection Test A, Digit Symbol Test, and spectral analysis of the electroencephalogram.

Results: Twenty-five patients (22%) were diagnosed as having subclinical hepatic encephalopathy. Patients with subclinical hepatic encephalopathy were older, had a higher Child-Pugh score, and more often had esophageal or gastric varices and episode(s) of clinical hepatic encephalopathy in their history. During a median follow-up of 29 months (range, 1-49 months), patients with subclinical hepatic encephalopathy significantly more often had episodes of clinical hepatic encephalopathy; survival, however, was similar to that of patients without subclinical hepatic encephalopathy, and was determined mainly by the Child-Pugh score. The Child-Pugh score was also superior to subclinical hepatic encephalopathy in predicting episodes of clinical hepatic encephalopathy.

Conclusions: The prognostic significance of subclinical hepatic encephalopathy appears limited.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Electroencephalography
  • Esophageal and Gastric Varices / complications
  • Female
  • Hepatic Encephalopathy / complications
  • Hepatic Encephalopathy / diagnosis
  • Hepatic Encephalopathy / mortality
  • Hepatic Encephalopathy / physiopathology*
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / physiopathology
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Prognosis
  • Severity of Illness Index
  • Survival Analysis