Overt Hepatic Encephalopathy: More Than Meets the Eye.

Erminelli, Davide; Mangini, Chiara; Zarantonello, Lisa; Angeli, Paolo; Montagnese, Sara · Am J Gastroenterol · 2024

cross_sectional · Level IV

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Abstract

We aimed to assess the reliability of a qualitative approach to overt hepatic encephalopathy (OHE) diagnosis compared with the semiquantitative, and recommended one. The above 2 methods were compared in 411 outpatients (71% males, 60 ± 10 years, model for end-stage liver disease 13.5 ± 5.0). Of the 73 patients with OHE on quantitative assessment, 19 (26%) were missed on qualitative assessment, with no difference in the likelihood of the physician missing grades II or III. Sixty-eight (20%) of the 270 patients with no OHE on quantitative assessment were wrongly qualified as having OHE. Qualitative clinical evaluation of OHE is not reliable, and recommendations should be followed.

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