Optimal treatment of hepatic encephalopathy: an update.

Optimal treatment of hepatic encephalopathy: an update.
Minerva Gastroenterol Dietol. 2016 Oct 20;
Authors: Allampati S, Mullen KD
Abstract
Hepatic Encephalopathy (HE) is a complex neuropsychiatric syndrome associated with decompensated liver disease. The spectrum of disease ranges from trivial abnormalities in complex decision making and prolonged reaction time to coma in its most severe form1. The very initial stages, recently termed covert Hepatic Encephalopathy (CHE), can only be diagnosed with the help of neuropsychiatric testing while the later and more severe forms, termed overt Hepatic Encephalopathy (OHE), can be diagnosed clinically. Severity of HE is graded based on West Haven Criteria and please refer to table 1 for more details2. Hepatic Encephalopathy is commonly seen with cirrhosis and onset of OHE results in poor prognosis with survival at 1 year at 20-40% and 3 year survival at 15-20%3,4,5. If HE requires management in the intensive care unit the one year mortality is significantly higher at 54%6. Wong et al noted that patients with HE at the time of transplant waitlist registration had increased mortality at 90 days when compared to patients without HE7. Moreover, patients with CHE had increased risk of developing OHE within 6 months8. HE is not only a burden for the patients but also to the health care system. In the United States, increased utilization of resources by HE patients was noted over a five year period ...

Source: Minerva Gastroenterologica e Dietologica - October 22, 2016 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research