Work

Utility of Psychometric Hepatic Encephalopathy Score in Diagnosing Minimal Hepatic Encephalopathy Among Liver Cirrhosis Patients in Nigeria

Year: 2025

Type: article

Abstract: INTRODUCTION: Hepatic encephalopathy (HE) is a critical complication of liver cirrhosis, with minimal hepatic encephalopathy (MHE) representing a subtle neurocognitive disorder within its spectrum, characterized by cognitive and motor impairments undetectable by routine clinical examinations. The Psychometric Hepatic Encephalopathy Score (PHES), comprising five psychometric tests, is the gold standard for MHE diagnosis, enabling early intervention to prevent accidents, falls, progression to overt HE, and reduced quality of life. The study aimed to establish a local PHES reference value in Nigeria and evaluate its utility in diagnosing MHE among liver cirrhosis patients. METHODS: It is a cross-sectional study; 200 apparently healthy controls and 85 liver cirrhosis patients without overt HE underwent PHES testing, including Number Connection test-A (NCT-A), Number Connection test-B (NCT-B), Digit Symbol Test (DST), Serial Dotting Test (SDT), and Line Tracing Test (LTT). RESULTS: The mean age of the liver cirrhosis patients was 40.5 ± 11.8 years, with a male-to-female ratio of 2.4:1, comparable to the controls. MHE was diagnosed at PHES < -5, revealing a prevalence of 51.8%. Risk factors associated with MHE included serum albumin, prothrombin time, and Child-Pugh score (p < 0.05), with Child-Pugh score (OR 9.3) and prothrombin time (OR 19.5) as independent predictors. Subtest combinations (NCT-A + NCT-B, NCT-A + SDT) showed sensitivities of 84.1% and 86.4%, respectively, and 61% specificity, reducing test time by 52%. CONCLUSION: The high MHE prevalence underscores the need for PHES validation across Nigeria to develop national diagnostic guidelines.

Source: Cureus

DOI: 10.7759/cureus.94682

Author: Mansur F Mohammed

Institution: University Hospitals of Derby and Burton NHS Foundation Trust

Language: English

Topic: Liver Disease and Transplantation

Subfield: Hepatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4415268393