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Natural history of covert hepatic encephalopathy: An observational study of 366 cirrhotic patients

An-Jiang Wang1, A-Ping Peng1, Bi-Min Li1

  • 1Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.

World Journal of Gastroenterology
|October 5, 2017
PubMed

Insights

Covert hepatic encephalopathy (CHE) in cirrhosis patients can worsen, persist, or resolve without treatment. Identifying CHE and its predictors aids in managing complications and mortality.

Area of Science:

  • Hepatology
  • Gastroenterology
  • Internal Medicine

Background:

  • Covert hepatic encephalopathy (CHE) is a subtle form of liver dysfunction.
  • Its natural history and impact on cirrhosis progression without intervention are not fully understood.

Purpose of the Study:

  • To investigate the natural progression of CHE in cirrhotic patients.
  • To identify factors influencing CHE outcomes, including overt HE, complications, and mortality.

Main Methods:

  • A cohort of 366 cirrhotic outpatients was assessed for CHE.
  • Patients were followed for approximately 11 months, recording cirrhosis-related complications, CHE resolution, and mortality.
  • Predictors for complications and death were analyzed.

Main Results:

  • CHE was diagnosed in 35.8% of patients.
  • CHE patients exhibited higher rates of death and hospitalization for complications, including overt HE (OHE).
  • Predictors for OHE included low serum albumin; high creatinine predicted mortality; Child-Pugh B/C and OHE history predicted CHE resolution.

Conclusions:

  • CHE's course is variable, with exacerbation, persistence, or spontaneous resolution occurring without treatment.
  • Predictive factors identified can guide patient triage and management strategies.
  • This understanding supports more cost-effective care for cirrhosis patients with CHE.
Abstract

Keywords:
Covert hepatic encephalopathyLiver cirrhosisNatural historyOvert hepatic encephalopathy

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