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A simple survey effectively screens for hepatic encephalopathy (HE) in cirrhosis patients. Patient-reported cognitive function predicts hospitalizations, offering a practical tool for managing this common complication.

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Area of Science:

  • Hepatology
  • Neuroscience
  • Clinical Medicine

Background:

  • Hepatic encephalopathy (HE) is a common, serious complication of cirrhosis, leading to hospitalizations and mortality.
  • Current screening methods for HE are underutilized due to time, equipment, and personnel constraints.
  • Effective HE screening is crucial for improving patient outcomes and reducing healthcare burdens.

Purpose of the Study:

  • To investigate the association between patient-reported cognitive function and objective cognitive measures in cirrhosis patients.
  • To determine if patient-reported cognitive function can predict hospitalizations in individuals with cirrhosis.
  • To evaluate the utility of a brief Patient-Reported Outcomes Measurement Information System (PROMIS) survey for HE screening.

Main Methods:

  • A single-center prospective study enrolled adult patients undergoing liver transplantation evaluation.
  • Cognitive function was assessed using the National Institutes of Health Toolbox Cognition Battery and a PROMIS cognitive function survey (PROMISCF).
  • Correlation and multivariate analyses were performed to assess the relationship between PROMISCF and cognitive tests, and to predict hospitalizations.

Main Results:

  • Twenty-three liver transplant candidates were enrolled, with a mean MELD-Na score of 14.9.
  • PROMISCF scores showed a significant correlation with the List Sort Working Memory test (r = 0.45, P = .03).
  • PROMISCF was a significant predictor of total hospitalization days (P < .001), hospital admissions (P = .01), and hospitalization rate (P < .001).

Conclusions:

  • A brief PROMIS cognitive function survey can effectively screen for HE in patients with cirrhosis.
  • Patient-reported cognitive function, as measured by PROMISCF, accurately predicts future hospitalizations.
  • This brief survey offers a practical and accessible tool for routine HE screening and management in clinical settings.