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Published on: May 16, 2015
Overt Hepatic Encephalopathy: More Than Meets the Eye
Davide Erminelli1, Chiara Mangini1, Lisa Zarantonello1
1Department of Medicine, University of Padova, Padova, Italy.
Introduction:
We aimed to assess the reliability of a qualitative approach to overt hepatic encephalopathy (OHE) diagnosis compared with the semiquantitative, and recommended one.
Methods:
The above 2 methods were compared in 411 outpatients (71% males, 60 ± 10 years, model for end-stage liver disease 13.5 ± 5.0).
Results:
Of the 73 patients with OHE on quantitative assessment, 19 (26%) were missed on qualitative assessment, with no difference in the likelihood of the physician missing grades II or III. Sixty-eight (20%) of the 270 patients with no OHE on quantitative assessment were wrongly qualified as having OHE.
Discussion:
Qualitative clinical evaluation of OHE is not reliable, and recommendations should be followed.
