Related Experiment Video
Updated: Jun 7, 2026
10:59
Investigations on Alterations of Hippocampal Circuit Function Following Mild Traumatic Brain Injury
Published on: November 19, 2012
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
Summary
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.
More Related Videos
Related Concept Videos
01:29Hepatic Encephalopathy
DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...
01:14Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug
In pharmacotherapy, monitoring drug concentrations is paramount, especially for drugs whose therapeutic effects hinge on both the active compound and its metabolite. Hepatic impairment profoundly influences drug potency by altering liver function. If the drug is more potent than its metabolite, impaired liver function amplifies drug activity due to elevated drug concentration levels. Conversely, if the metabolite holds greater potency, diminished liver function diminishes drug activity by...
01:08Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...