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Minimal hepatic encephalopathy is associated with falls

Eva Román1, Joan Córdoba, Maria Torrens

  • 1CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.

The American Journal of Gastroenterology
|October 28, 2010
PubMed
Abstract

Insights

Minimal hepatic encephalopathy (MHE) significantly increases fall risk in cirrhosis patients, especially those on psychoactive drugs. This association leads to higher healthcare needs and hospitalizations.

Area of Science:

  • Hepatology
  • Neurology
  • Geriatrics

Background:

  • Minimal hepatic encephalopathy (MHE) impairs quality of life and daily functioning in cirrhosis patients.
  • MHE is known to affect driving ability, but its link to falls is under-researched.
  • Falls in cirrhosis patients carry severe risks due to coagulopathy, osteoporosis, and surgical complications.

Purpose of the Study:

  • To investigate the association between MHE and falls in patients with cirrhosis.
  • To determine if MHE is an independent risk factor for falls in this population.

Main Methods:

  • Retrospective study including 130 cirrhotic outpatients and 43 controls.
  • MHE diagnosis based on the psychometric hepatic encephalopathy score (PHES).
  • Data collected on fall incidence, injury severity, and healthcare utilization in the prior 12 months.

Main Results:

  • 34.6% of cirrhosis patients had MHE; 40% of these reported falls versus 12.9% without MHE (P<0.001).
  • MHE patients had increased need for primary healthcare services (8.8% vs 0%, P=0.004).
  • MHE, prior encephalopathy, and antidepressant therapy were independent predictors of falls (OR 2.91, 2.87, 3.91 respectively).

Conclusions:

  • Falls are more common in cirrhotic patients with MHE.
  • The association between MHE and falls is amplified in patients using psychoactive medications.
  • Falls in MHE patients represent a significant burden on healthcare resources and hospitalization rates.

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