Evaluation of Quality of Life and Risk Factors in Patients With Covert Hepatic Encephalopathy Including Those With...

Covert hepatic encephalopathy (CHE) is associated with a decline in quality of life (QOL), requiring early detection and intervention. We aimed to determine CHE prevalence, QOL correlations, and risk factors in hospitalized patients with cirrhosis. This study evaluated neuropsychological test (NPT) results and QOL in these patients.

This retrospective study included 56 patients with liver cirrhosis who were hospitalized at our institution from January to November 2024 and underwent simultaneous short form health survey (SF-36) testing and NPT. The NPT included the number connection (NCT)-A and Stroop tests. QOL was assessed using the SF-36, and risk factors evaluated using hematological data at admission.

The mean patient age was 67.5 years, with 39 men and 17 women. Hepatocellular carcinoma was observed in 35 patients (63%). Underlying liver diseases were: hepatitis C virus in seven patients, hepatitis B virus in four, alcohol damage in 16, metabolic dysfunction-associated steatohepatitis in 10, autoimmune hepatitis in four, and others in 15. CHE was detected in 24 patients (43%): three (13%) with abnormal NCT-A findings, 14 (58%) with abnormal Stroop findings, and seven (29%) with both abnormalities. On SF-36 assessment, patients with CHE had significantly lower role-physical (RP) scores than those without CHE [30.80 (2.55-55.72) vs. 49.07 (12.52-55.72), p=0.022]. Furthermore, role-emotion and vitality tended to be lower in patients with CHE. Patients with CHE also had significantly lower Zn levels than those without [67 (42-110) vs. 81 (44-190); p=0.016].

Patients with CHE experienced reduced QOL RP and low Zn levels, suggesting that early Zn supplementation may improve CHE and enhance QOL.