A PROSPECTIVE STUDY TO ASSESS PREVALENCE OF MINIMAL HEPATIC ENCEPHALOPATHY IN CIRRHOTIC PATIENTS AND IMPACT OF PATIENT COUNSELLING IN IMPROVING BASELINE KNOWLEDGE OF CIRRHOTIC PATIENTS

Meenakshi S., Jithin Mathew, Chinju D.S. and Unnikrishnan L.S.*

ABSTRACT

Aim: Psychometric hepatic encephalopathy score is considered as the simplest method for detection of MHE. This study aims to assess the prevalence of minimal hepatic encephalopathy in patients with liver cirrhosis, thus provide appropriate treatment and to prevent its progression to overt hepatic encephalopathy. Materials and methods: 52 patients with a mean age of 56.712±9.293years with liver cirrhosis who met up with the inclusion and exclusion criteria were included in the study. All subjects underwent psychometric tests which include number connection test A and B (NCT-A), figure connection test A (FCT-A) line tracing test (LTT), serial dotting test (SDT), and digital symbol test(DST) in the same day. Result: Prevalence of MHE was found to be 65.38% which was detected with a psychometric hepatic encephalopathy score ≤ - 5.Twelve patients with a mean age of 56.712±9.293 years completed all the five tests. 69.23% involved in the study were male respondents and 30.77% belongs to female population. The etiology for liver cirrhosis was found to be alcoholism (42.31%), hepatitis B (13.46%), hepatitis C (11.54%) and 32.69% due to primary sclerosing cholangitis, autoimmune hepatitis and steatohepatitis. Among subjects with MHE 50%belongs to CTP-A, 55.56% belongs to CTP-B and 93.75% belongs to CTP-C. The mean PHES was found to be -5.173±2.185points (median, -5; range, -2 to -10). Conclusion: MHE as undetectable mostly from any laboratory tests requires a validated diagnostic procedure but much more simple than critical flicker frequency in order to be performed in an outpatient setting. This defines the importance of PHES in MHE detection. More studies need to be conducted on this topic as PHES has prognostic significance on survival of liver cirrhotic patients.

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