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Diagnosis of minimal hepatic encephalopathy in a tertiary care center from eastern Romania: validation of the psychometric hepatic encephalopathy score (PHES).
Metab Brain Dis. 2016 12; 31(6):1463-1471.MB

Abstract

The psychometric hepatic encephalopathy score (PHES) is frequently used as a "gold standard" for the diagnosis of minimal hepatic encephalopathy (MHE). In Romania, there are currently no widely available tests for the detection of MHE. In this study we aimed to standardize the PHES in a healthy Romanian population and to estimate the prevalence of MHE in a group of Romanian patients with liver cirrhosis. A total of 260 healthy volunteers and 106 patients with liver cirrhosis were included in the study. The five neuropsychological tests comprising the PHES were administered to all enroled subjects. Blood samples for routine tests and serum ammonia were collected. In the healthy volunteer group age and education years were found to be predictors of all tests and gender only in two tests: digit symbol test and serial dotting test. The PHES of the healthy volunteer group was 0,43 ± 1,37 and the cut-off between normal and pathological values was set at -3 points. In the liver cirrhosis group the mean PHES was -2,44 ± 3,41, significantly lower than in the control group (p = 0,001). The estimated prevalence of MHE was 34,7 % (37 patients). In patients with cirrhosis there was a significant correlation between PHES and the severity of the liver disease according to Child-Pugh classification (r = 0,529, p = 0,001) and MELD score (r = -0,525, p = 0,001). According to our results, accurate Romanian PHES norms for the diagnosis of MHE have been developed. MHE was diagnosed in a significant proportion of Romanian patients with liver cirrhosis.

Authors+Show Affiliations

Department of Gastroenterology, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Strada Universitatii, Nr. 16, code, 700115, Iasi, Romania. badea.mircea.alexandru@gmail.com. Institute of Gastroenterology and Hepatology, Iasi, Romania. badea.mircea.alexandru@gmail.com.Department of Gastroenterology, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Strada Universitatii, Nr. 16, code, 700115, Iasi, Romania. Institute of Gastroenterology and Hepatology, Iasi, Romania.Department of Gastroenterology, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Strada Universitatii, Nr. 16, code, 700115, Iasi, Romania. Institute of Gastroenterology and Hepatology, Iasi, Romania.Department of Gastroenterology, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Strada Universitatii, Nr. 16, code, 700115, Iasi, Romania. Institute of Gastroenterology and Hepatology, Iasi, Romania.Department of Gastroenterology, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Strada Universitatii, Nr. 16, code, 700115, Iasi, Romania. Institute of Gastroenterology and Hepatology, Iasi, Romania.Department of Gastroenterology, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Strada Universitatii, Nr. 16, code, 700115, Iasi, Romania. Institute of Gastroenterology and Hepatology, Iasi, Romania.Department of Gastroenterology, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Strada Universitatii, Nr. 16, code, 700115, Iasi, Romania. Institute of Gastroenterology and Hepatology, Iasi, Romania.Department of Gastroenterology, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Strada Universitatii, Nr. 16, code, 700115, Iasi, Romania. Institute of Gastroenterology and Hepatology, Iasi, Romania.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27461111

Citation

Badea, Mircea Alexandru, et al. "Diagnosis of Minimal Hepatic Encephalopathy in a Tertiary Care Center From Eastern Romania: Validation of the Psychometric Hepatic Encephalopathy Score (PHES)." Metabolic Brain Disease, vol. 31, no. 6, 2016, pp. 1463-1471.
Badea MA, Drug VL, Dranga M, et al. Diagnosis of minimal hepatic encephalopathy in a tertiary care center from eastern Romania: validation of the psychometric hepatic encephalopathy score (PHES). Metab Brain Dis. 2016;31(6):1463-1471.
Badea, M. A., Drug, V. L., Dranga, M., Gavrilescu, O., Stefanescu, G., Popa, I., Mihai, C., & Cijevschi-Prelipcean, C. (2016). Diagnosis of minimal hepatic encephalopathy in a tertiary care center from eastern Romania: validation of the psychometric hepatic encephalopathy score (PHES). Metabolic Brain Disease, 31(6), 1463-1471.
Badea MA, et al. Diagnosis of Minimal Hepatic Encephalopathy in a Tertiary Care Center From Eastern Romania: Validation of the Psychometric Hepatic Encephalopathy Score (PHES). Metab Brain Dis. 2016;31(6):1463-1471. PubMed PMID: 27461111.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis of minimal hepatic encephalopathy in a tertiary care center from eastern Romania: validation of the psychometric hepatic encephalopathy score (PHES). AU - Badea,Mircea Alexandru, AU - Drug,Vasile Liviu, AU - Dranga,Mihaela, AU - Gavrilescu,Otilia, AU - Stefanescu,Gabriela, AU - Popa,Iolanda, AU - Mihai,Catalina, AU - Cijevschi-Prelipcean,Cristina, Y1 - 2016/07/27/ PY - 2016/03/11/received PY - 2016/07/19/accepted PY - 2016/7/28/pubmed PY - 2018/1/9/medline PY - 2016/7/28/entrez KW - Liver cirrhosis KW - Minimal hepatic encephalopathy KW - Neuropsychological test KW - Psychometric hepatic encephalopathy score SP - 1463 EP - 1471 JF - Metabolic brain disease JO - Metab Brain Dis VL - 31 IS - 6 N2 - The psychometric hepatic encephalopathy score (PHES) is frequently used as a "gold standard" for the diagnosis of minimal hepatic encephalopathy (MHE). In Romania, there are currently no widely available tests for the detection of MHE. In this study we aimed to standardize the PHES in a healthy Romanian population and to estimate the prevalence of MHE in a group of Romanian patients with liver cirrhosis. A total of 260 healthy volunteers and 106 patients with liver cirrhosis were included in the study. The five neuropsychological tests comprising the PHES were administered to all enroled subjects. Blood samples for routine tests and serum ammonia were collected. In the healthy volunteer group age and education years were found to be predictors of all tests and gender only in two tests: digit symbol test and serial dotting test. The PHES of the healthy volunteer group was 0,43 ± 1,37 and the cut-off between normal and pathological values was set at -3 points. In the liver cirrhosis group the mean PHES was -2,44 ± 3,41, significantly lower than in the control group (p = 0,001). The estimated prevalence of MHE was 34,7 % (37 patients). In patients with cirrhosis there was a significant correlation between PHES and the severity of the liver disease according to Child-Pugh classification (r = 0,529, p = 0,001) and MELD score (r = -0,525, p = 0,001). According to our results, accurate Romanian PHES norms for the diagnosis of MHE have been developed. MHE was diagnosed in a significant proportion of Romanian patients with liver cirrhosis. SN - 1573-7365 UR - https://www.unboundmedicine.com/medline/citation/27461111/Diagnosis_of_minimal_hepatic_encephalopathy_in_a_tertiary_care_center_from_eastern_Romania:_validation_of_the_psychometric_hepatic_encephalopathy_score__PHES__ L2 - https://doi.org/10.1007/s11011-016-9878-y DB - PRIME DP - Unbound Medicine ER -