Related Experiment Video
Updated: Aug 19, 2025
Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
A simple covert hepatic encephalopathy screening model based on blood biochemical parameters in patients with
Takao Miwa1,2, Tatsunori Hanai1,3, Kayoko Nishimura3
1Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan.
Insights
A new simple score using blood tests can help identify covert hepatic encephalopathy (CHE) in liver cirrhosis patients. This score also predicts the development of overt hepatic encephalopathy (OHE).
Area of Science:
- Hepatology
- Biochemistry
- Clinical Diagnostics
Background:
- Covert hepatic encephalopathy (CHE) negatively impacts liver cirrhosis patient outcomes.
- Diagnosing CHE is challenging due to its subtle presentation.
- Biochemical markers offer a potential avenue for CHE screening.
Purpose of the Study:
- To develop a simple screening model for CHE using blood biochemical parameters.
- To assess the utility of the simple CHE (sCHE) score in identifying CHE.
- To evaluate the sCHE score's ability to predict overt hepatic encephalopathy (OHE).
Main Methods:
- Retrospective study of 439 liver cirrhosis patients.
- Development of the sCHE score based on hypoalbuminemia and hyperammonemia.
- Logistic regression and competing risk regression models used for analysis.
Main Results:
- 79 out of 381 eligible patients (21%) were diagnosed with CHE.
- An sCHE score of 1 or higher was associated with a higher prevalence of CHE (27% vs. 14%).
- The sCHE score independently predicted OHE development (SHR, 2.69).
Conclusions:
- The sCHE score serves as an effective screening tool for identifying CHE.
- The sCHE score is valuable for predicting the future occurrence of OHE in liver cirrhosis patients.
Aim:
Covert hepatic encephalopathy (CHE) adversely affects clinical outcomes in patients with liver cirrhosis, although its diagnosis is difficult. This study aimed to establish a simple CHE screening model based on blood-related biochemical parameters.
Methods:
This retrospective study enrolled 439 patients who were assessed for CHE using a neuropsychiatric test between January 2011 and June 2019. A simple CHE (sCHE) score was calculated with hypoalbuminemia (≤ 3.5 g/dL) and hyperammonemia (≥ 80 μg/dL) as 1 point each. The association between sCHE score and CHE or overt hepatic encephalopathy (OHE) was assessed using logistic regression and Fine-Gray competing risk regression models.
Results:
Of 381 eligible patients, 79 (21%) were diagnosed with CHE. The distribution of sCHE scores was 48% with 0 point, 33% with 1 point, and 19% with 2 points. Patients with sCHE score ≥ 1 point had a higher prevalence of CHE than those with sCHE score of 0 (27% vs. 14%, P = 0.002). A cut-off value of 1 point showed high discriminative ability for identifying CHE, with a sensitivity of 0.67, specificity of 0.56, positive predictive value of 0.27, and negative predictive value of 0.86. During the median follow-up period of 2.2 years, 58 (15%) patients developed OHE. Multivariate analysis showed that sCHE score ≥ 1 (sub-distribution hazard ratio [SHR], 2.69; 95% confidence interval [CI], 1.41-5.15) and CHE (SHR, 2.17; 95% CI, 1.26-3.73) independently predicted OHE.
Conclusions:
The sCHE score is a useful screening model for identifying patients with CHE and for predicting OHE occurrence.
More Related Videos
07:27The Murine Choline-Deficient, Ethionine-Supplemented CDE Diet Model of Chronic Liver Injury
Published on: October 21, 2017
10:40Visualization and Analysis of Blood Flow and Oxygen Consumption in Hepatic Microcirculation: Application to an Acute Hepatitis Model
Published on: August 4, 2012