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Extrapyramidal signs predict the development of overt hepatic encephalopathy in patients with liver cirrhosis.
Eur J Gastroenterol Hepatol. 2010 May; 22(5):519-25.EJ

Abstract

BACKGROUND/AIMS

The long-term evolution of cirrhotic patients with extrapyramidal signs has not yet been studied. We have investigated the influence of extrapyramidal signs on the prognosis, evolution, and quality of life of patients with liver cirrhosis.

METHODS

Forty-six patients with cirrhosis were followed up and 18 of them were reevaluated, a mean of 45 months later. Cognitive impairment was measured with psychometric tests (Trail-Making Test part A, Grooved-Pegboard, Block-Design, Oral Symbol Digit and Stroop Test). Extrapyramidal signs were evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS). Health-related quality of life was measured using the SF-36 scale and the Chronic Liver Disease Questionnaire.

RESULTS

Eleven of the 46 patients who were followed up developed overt hepatic encephalopathy (HE) during the follow-up. The presence of extrapyramidal signs was the unique factor that predicted overt HE and patients with basal higher score in the part 3 of the UPDRS developed overt HE more frequently [hazard ratio=1.29; 95% confidence interval (1.04-1.60) P=0.023]. In the 18 reevaluated patients, there was an increase in the score of the UPDRS part 3 after follow-up. There was a worsening in the score values of the block design and the Number Connection Test. In health-related quality of life scales, patients scored better in the area of mental health of the SF-36 scale. Patients with extrapyramidal signs persisted with worse scores in several items of the SF-36 scale and the Chronic Liver Disease Questionnaire.

CONCLUSION

The presence of extrapyramidal signs in patients with liver cirrhosis predicts the development of overt HE. These signs increased along the follow-up, and remain a bad influence on quality of life.

Authors+Show Affiliations

Unidad de Gastroenterología, Hospital General Universitario de Alicante, Alicante, Spain.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20010298

Citation

Compañy, Luis, et al. "Extrapyramidal Signs Predict the Development of Overt Hepatic Encephalopathy in Patients With Liver Cirrhosis." European Journal of Gastroenterology & Hepatology, vol. 22, no. 5, 2010, pp. 519-25.
Compañy L, Zapater P, Pérez-Mateo M, et al. Extrapyramidal signs predict the development of overt hepatic encephalopathy in patients with liver cirrhosis. Eur J Gastroenterol Hepatol. 2010;22(5):519-25.
Compañy, L., Zapater, P., Pérez-Mateo, M., & Jover, R. (2010). Extrapyramidal signs predict the development of overt hepatic encephalopathy in patients with liver cirrhosis. European Journal of Gastroenterology & Hepatology, 22(5), 519-25. https://doi.org/10.1097/MEG.0b013e328333df0f
Compañy L, et al. Extrapyramidal Signs Predict the Development of Overt Hepatic Encephalopathy in Patients With Liver Cirrhosis. Eur J Gastroenterol Hepatol. 2010;22(5):519-25. PubMed PMID: 20010298.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extrapyramidal signs predict the development of overt hepatic encephalopathy in patients with liver cirrhosis. AU - Compañy,Luis, AU - Zapater,Pedro, AU - Pérez-Mateo,Miguel, AU - Jover,Rodrigo, PY - 2009/12/17/entrez PY - 2009/12/17/pubmed PY - 2010/7/10/medline SP - 519 EP - 25 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 22 IS - 5 N2 - BACKGROUND/AIMS: The long-term evolution of cirrhotic patients with extrapyramidal signs has not yet been studied. We have investigated the influence of extrapyramidal signs on the prognosis, evolution, and quality of life of patients with liver cirrhosis. METHODS: Forty-six patients with cirrhosis were followed up and 18 of them were reevaluated, a mean of 45 months later. Cognitive impairment was measured with psychometric tests (Trail-Making Test part A, Grooved-Pegboard, Block-Design, Oral Symbol Digit and Stroop Test). Extrapyramidal signs were evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS). Health-related quality of life was measured using the SF-36 scale and the Chronic Liver Disease Questionnaire. RESULTS: Eleven of the 46 patients who were followed up developed overt hepatic encephalopathy (HE) during the follow-up. The presence of extrapyramidal signs was the unique factor that predicted overt HE and patients with basal higher score in the part 3 of the UPDRS developed overt HE more frequently [hazard ratio=1.29; 95% confidence interval (1.04-1.60) P=0.023]. In the 18 reevaluated patients, there was an increase in the score of the UPDRS part 3 after follow-up. There was a worsening in the score values of the block design and the Number Connection Test. In health-related quality of life scales, patients scored better in the area of mental health of the SF-36 scale. Patients with extrapyramidal signs persisted with worse scores in several items of the SF-36 scale and the Chronic Liver Disease Questionnaire. CONCLUSION: The presence of extrapyramidal signs in patients with liver cirrhosis predicts the development of overt HE. These signs increased along the follow-up, and remain a bad influence on quality of life. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/20010298/Extrapyramidal_signs_predict_the_development_of_overt_hepatic_encephalopathy_in_patients_with_liver_cirrhosis_ L2 - http://dx.doi.org/10.1097/MEG.0b013e328333df0f DB - PRIME DP - Unbound Medicine ER -