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Article

Screening for minimal hepatic encephalopathy in patients with cirrhosis by cirrhosis-related symptoms and a history of overt hepatic encephalopathy

  • Authors:
    • Emi Yoshimura
    • Tatsuki Ichikawa
    • Hisamitsu Miyaaki
    • Naota Taura
    • Satoshi Miuma
    • Hidataka Shibata
    • Takuya Honda
    • Fuminao Takeshima
    • Kazuhiko Nakao
  • View Affiliations / Copyright

    Affiliations: Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852‑8501, Japan, Department of Gastroenterology, Nagasaki Harbor Medical Center, City Hospital, Nagasaki 850‑8555, Japan
  • Pages: 193-198
    |
    Published online on: June 13, 2016
       https://doi.org/10.3892/br.2016.702
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Abstract

The diagnosis of minimal hepatic encephalopathy (MHE) is more difficult in comparison to the diagnosis of overt hepatic encephalopathy (OHE), as patients with MHE do not exhibit overt neurological deficits and must be diagnosed using specialized equipment. However, identifying MHE is critical for patients with cirrhosis, and a simple screening test is required. The present study aimed to evaluate the associations between MHE, clinical characteristics and questionnaire items regarding sleep disturbances and cirrhosis‑related symptom score (CSS). A total of 91 patients who had cirrhosis without OHE were evaluated using various questionnaires [i.e., CSS, Epworth Sleepiness Scale, the Japanese version of the Pittsburgh Sleep Quality Index (PSQI) and the Japanese 36‑item short‑form health survey (SF‑36)]. MHE was diagnosed using the neuropsychological test. MHE was associated with severe liver damage, which was indicated by liver damage markers and a history of OHE. In addition, MHE was associated with the CSS, PSQI and SF‑36 results. The multivariate analyses revealed that a history of OHE was the factor that was the most strongly associated with MHE. Among patients without a history of OHE, MHE was most strongly associated with CSS, although it was also associated with severe liver damage and platelet counts. A prediction score (calculated using a history of OHE and CSS) provided an area under the receiver operating characteristic curve of 0.738 and a sensitivity of 0.671 for identifying MHE. In conclusion, a history of OHE and CSS may be useful for identifying MHE in patients with cirrhosis.
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Copy and paste a formatted citation
Spandidos Publications style
Yoshimura E, Ichikawa T, Miyaaki H, Taura N, Miuma S, Shibata H, Honda T, Takeshima F and Nakao K: Screening for minimal hepatic encephalopathy in patients with cirrhosis by cirrhosis-related symptoms and a history of overt hepatic encephalopathy. Biomed Rep 5: 193-198, 2016.
APA
Yoshimura, E., Ichikawa, T., Miyaaki, H., Taura, N., Miuma, S., Shibata, H. ... Nakao, K. (2016). Screening for minimal hepatic encephalopathy in patients with cirrhosis by cirrhosis-related symptoms and a history of overt hepatic encephalopathy. Biomedical Reports, 5, 193-198. https://doi.org/10.3892/br.2016.702
MLA
Yoshimura, E., Ichikawa, T., Miyaaki, H., Taura, N., Miuma, S., Shibata, H., Honda, T., Takeshima, F., Nakao, K."Screening for minimal hepatic encephalopathy in patients with cirrhosis by cirrhosis-related symptoms and a history of overt hepatic encephalopathy". Biomedical Reports 5.2 (2016): 193-198.
Chicago
Yoshimura, E., Ichikawa, T., Miyaaki, H., Taura, N., Miuma, S., Shibata, H., Honda, T., Takeshima, F., Nakao, K."Screening for minimal hepatic encephalopathy in patients with cirrhosis by cirrhosis-related symptoms and a history of overt hepatic encephalopathy". Biomedical Reports 5, no. 2 (2016): 193-198. https://doi.org/10.3892/br.2016.702
Copy and paste a formatted citation
x
Spandidos Publications style
Yoshimura E, Ichikawa T, Miyaaki H, Taura N, Miuma S, Shibata H, Honda T, Takeshima F and Nakao K: Screening for minimal hepatic encephalopathy in patients with cirrhosis by cirrhosis-related symptoms and a history of overt hepatic encephalopathy. Biomed Rep 5: 193-198, 2016.
APA
Yoshimura, E., Ichikawa, T., Miyaaki, H., Taura, N., Miuma, S., Shibata, H. ... Nakao, K. (2016). Screening for minimal hepatic encephalopathy in patients with cirrhosis by cirrhosis-related symptoms and a history of overt hepatic encephalopathy. Biomedical Reports, 5, 193-198. https://doi.org/10.3892/br.2016.702
MLA
Yoshimura, E., Ichikawa, T., Miyaaki, H., Taura, N., Miuma, S., Shibata, H., Honda, T., Takeshima, F., Nakao, K."Screening for minimal hepatic encephalopathy in patients with cirrhosis by cirrhosis-related symptoms and a history of overt hepatic encephalopathy". Biomedical Reports 5.2 (2016): 193-198.
Chicago
Yoshimura, E., Ichikawa, T., Miyaaki, H., Taura, N., Miuma, S., Shibata, H., Honda, T., Takeshima, F., Nakao, K."Screening for minimal hepatic encephalopathy in patients with cirrhosis by cirrhosis-related symptoms and a history of overt hepatic encephalopathy". Biomedical Reports 5, no. 2 (2016): 193-198. https://doi.org/10.3892/br.2016.702
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