Prevalence and risk factors for minimal hepatic encephalopathy in cirrhotic patients with different etiologies

Li, Xiaoyan1,2; Liu, Shanghao3; Xiang, Huiling4; Zhang, Qingge5; Guo, Ying6; Zu, Hongmei7; Wang, Jing8; Lv, Jiaojian9; Zhang, Xiaoning2; Meng, Fanping2; Li, Jiahuan10; Li, Jie11; Bianba, Yangzhen12; Shang, Jia13; Zhang, Guo14; Liu, Fei15; Tong, Zhaowei16; Lei, Chuang17; Ye, Wei18; Yang, Qiaohua19; Wang, Ningning20; Song, Ying21; Fu, Wei22; Li, Ziyue23; Gao, Yanjing24; Zhang, Yongping25; Chen, Jiafang26; Wu, Caiyun27; Zheng, Qi28; Wang, Fang29; Yu, Jiali30; Lin, Lianjie31; Yang, Chuanlong32; Yang, Xiaoting33; Ye, Xiaomin34; Wang, Xiangmei35; Zhao, Xuelan36; Qi, Xiaolong37; Wang, Fusheng1,2; Fu, Junliang1,38

2023-12-01

10.1002/poh2.65

PORTAL HYPERTENSION & CIRRHOSIS   影响因子和分区

2770-5838

2770-5846

Aims: Minimal hepatic encephalopathy (MHE) significantly affects the prognosis of patients with cirrhosis. This study was performed to determine whether there is a difference in the prevalence of MHE among patients with cirrhosis of different etiologies and whether the etiology directly influences the occurrence of MHE. Methods: This multicenter, cross-sectional study enrolled 1879 patients with confirmed cirrhosis at 40 hospitals from October 25, 2021, to January 10, 2023 (Trial registration: ). The patients' demographics, etiologies of cirrhosis, and laboratory test results were collected. The psychometric hepatic encephalopathy score (PHES) was determined in all patients to screen for MHE. Multivariate logistic analyses were performed to identify the risk factors for MHE. Results: In total, 736 patients with cirrhosis were analyzed. The prevalence of MHE was 42.0% (n = 309). The primary etiology among all patients was hepatitis B virus (HBV)-related cirrhosis (71.9% [529/736]). The prevalence of MHE was significantly higher in patients with alcoholic cirrhosis (57.1% [40/70]) than in those with HBV-related cirrhosis (40.6% [215/529], p = 0.009) or hepatitis C virus (HCV)-related cirrhosis (38.2% [26/68], p = 0.026). Age (odds ratio [OR], 1.042; 95% confidence interval [CI], 1.024-1.059; p < 0.001), duration of education (OR, 0.935; 95% CI, 0.899-0.971; p = 0.001), etiology (OR, 1.740; 95% CI, 1.028-2.945; p = 0.039), and high MELD-Na scores (OR, 1.038; 95% CI, 1.009-1.067; p = 0.009) were independent risk factors for MHE. When patients with cirrhosis of different etiologies were analyzed separately, the results showed that age (OR, 1.035; 95% CI, 1.014-1.057; p = 0.001) and duration of education (OR, 0.924; 95% CI, 0.883-0.966; p = 0.001) were risk factors for MHE among patients with HBV-related cirrhosis, whereas age (OR, 1.138; 95% CI, 1.033-1.254; p = 0.009) and creatinine concentration (OR, 16.487; 95% CI, 1.113-244.160; p = 0.042) were risk factors for MHE in patients with HCV-related cirrhosis. No risk factors for MHE were found in patients with autoimmune cirrhosis. For patients with alcoholic cirrhosis, the platelet count (OR, 1.014; 95% CI, 1.000-1.027; p = 0.045) was a risk factor for MHE. The PHES subtest results were inconsistent among patients who had MHE with cirrhosis of different etiologies. Patients with HBV-related cirrhosis performed better on Number Connection Test B and the serial dotting test than those with alcoholic cirrhosis (p = 0.007 and p < 0.001), better on Number Connection Test B than those with HCV-related cirrhosis (p = 0.020), and better on the line tracing test than those with autoimmune cirrhosis (p = 0.037). Conclusion: The etiology of cirrhosis affected the prevalence of MHE and risk factors for MHE. The domains of major cognitive impairment varied among patients with cirrhosis of different etiologies. Further studies are required to verify these findings.

etiology liver cirrhosis minimal hepatic encephalopathy psychometric hepatic encephalopathy score risk factors

ESCI

英语

其他

Innovation Groups of the National Natural Science Foundation of China[81721002] ; Capital Clinical Diagnosis and Treatment Technology Research and Transformation Application Project[Z201100005520046] ; Tianjin Key Medical Specialty Construction Project[TJYXZDXK-034A] ; Tianjin Health Science and Technology Project[TJWJ2022XK029]

Gastroenterology & Hepatology ; Cardiovascular System & Cardiology

Gastroenterology & Hepatology ; Peripheral Vascular Disease

WOS:001281396000002

WILEY

Web of Science

1.Med Sch Chinese PLA, Beijing, Peoples R China
2.Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Infect Dis, Med Ctr 5, Beijing, Peoples R China
3.Lanzhou Univ, Sch Clin Med 1, Lanzhou, Gansu, Peoples R China
4.Tianjin Third Cent Hosp, Inst Hepatobiliary Dis, Dept Gastroenterol & Hepatol, Tianjin Key Lab Extracorporeal Life Support Crit D, Tianjin, Peoples R China
5.Xingtai Peoples Hosp, Hepatol Dept Integrated Tradit Chinese & Western M, Xingtai, Hebei, Peoples R China
6.Third peoples Hosp Taiyuan, Dept Hepatol, Taiyuan, Shanxi, Peoples R China
7.Fourth Peoples Hosp Qinghai Prov, Dept Gastroenterol, Xining, Qinghai, Peoples R China
8.Baotou Med Coll, Affiliated Hosp 2, Dept Gastroenterol, Baotou, Inner Mongonia, Peoples R China
9.Lishui City Peoples Hosp, Dept Infect Dis, Lishui, Zhejiang, Peoples R China
10.Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Infect Dis, Wuhan, Hubei, Peoples R China
11.Nanjing Univ, Nanjing Drum Tower Hosp, Affiliated Hosp, Med Sch,Dept Infetc Dis, Nanjing, Jiangsu, Peoples R China
12.Third Peoples Hosp Tibet Autonomous Reg, Dept Hepatol, Lhasa, Xizang, Peoples R China
13.Henan Prov Peoples Hosp, Dept Infect Dis, Zhengzhou, Henan, Peoples R China
14.Peoples Hosp Guangxi Zhuang Autonomous Reg, Dept Gastroenterol, Nanning, Guangxi, Peoples R China
15.Cent South Univ, Xiangya Hosp, Dept Infect Dis, Hunan Key Lab Viral Hepatitis, Changsha, Hunan, Peoples R China
16.Huzhou Cent Hosp, Dept Infect Dis, Huzhou, Zhejiang, Peoples R China
17.First Peoples Hosp Changde City, Dept Infect Dis, Changde, Hunan, Peoples R China
18.Nanjing Univ Tradit Chinese Med, Nanjing Hosp, Liver Cirrhosis Treatment Ctr, Nanjing, Jiangsu, Peoples R China
19.First Peoples Hosp Huaihua, Hepatol Dept Infect Dis Ctr, Huaihua, Hunan, Peoples R China
20.China Med Univ, Hosp 1, Dept Gastroenterol, Shenyang, Liaoning, Peoples R China
21.Xian GaoXin Hosp, Dept Gastroenterol, Xian, Shaanxi, Peoples R China
22.Shenyang 739 Hosp, Dept Hepatol, Shenyang, Liaoning, Peoples R China
23.Hebei Med Univ, Hosp 3, Dept Infect Dis, Shijiazhuang, Hebei, Peoples R China
24.Shandong Univ, Qilu Hosp, Dept Gastroenterol, Jinan, Shandong, Peoples R China
25.Peoples Hosp Xinjiang Uygur Autonomous Reg, Dept Infect Dis, Urumqi, Xinjiang Uyghur, Peoples R China
26.Datong City Fourth Peoples Hosp, Dept Gastroenterol, Datong, Shanxi, Peoples R China
27.Third People's Hosp Linfen City, Dept Hepatol, Linfen, Shanxi, Peoples R China
28.Fujian Med Univ, Affiliated Hosp 1, Hepatol Res Inst, Dept Hepatol, Fuzhou, Fujian, Peoples R China
29.Southern Univ Sci & Technol, Shenzhen Peoples Hosp 3, Affiliated Hosp 2, Natl Clin Res Ctr Infect Dis,Sch Med,Dept Hepatol, Shenzhen, Guangdong, Peoples R China
30.Dalian Med Univ, Affiliated Hosp 1, Dept Gastroenterol, Dalian, Liaoning, Peoples R China
31.China Med Univ, Shengjing Hosp, Shenyang, Liaoning, Peoples R China
32.Shandong Publ Hlth Clin Ctr, Dept Severe Liver Dis, Jinan, Shandong, Peoples R China
33.Wuzhong Peoples Hosp, Dept Gastroenterol, Wuzhong, Ningxia, Peoples R China
34.Xichang Peoples Hosp, Dept Gastroenterol, Xichang, Sichuan, Peoples R China
35.Fujian Med Univ, Mengchao Hepatobiliary Hosp, Dept Severe Hepatol, Fuzhou, Fujian, Peoples R China
36.Chongqing Publ Hlth Med Ctr, Dept Gastroenterol Liver Dis, Chongqing, Peoples R China
37.Southeast Univ, Zhongda Hosp, Ctr Portal Hypertens, Med Sch,Dept Radiol, Nanjing, Jiangsu, Peoples R China
38.Chinese Peoples Liberat Army Gen Hosp, Med Ctr 5, Dept Infect Dis, Beijing, Peoples R China

Li, Xiaoyan,Liu, Shanghao,Xiang, Huiling,et al. Prevalence and risk factors for minimal hepatic encephalopathy in cirrhotic patients with different etiologies[J]. PORTAL HYPERTENSION & CIRRHOSIS,2023,2(4).

Li, Xiaoyan.,Liu, Shanghao.,Xiang, Huiling.,Zhang, Qingge.,Guo, Ying.,...&Fu, Junliang.(2023).Prevalence and risk factors for minimal hepatic encephalopathy in cirrhotic patients with different etiologies.PORTAL HYPERTENSION & CIRRHOSIS,2(4).

Li, Xiaoyan,et al."Prevalence and risk factors for minimal hepatic encephalopathy in cirrhotic patients with different etiologies".PORTAL HYPERTENSION & CIRRHOSIS 2.4(2023).