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Dig Dis Sci. 2008 Feb;53(2):529-38. Epub 2007 Aug 21.

Introduction to the Hepatic Encephalopathy Scoring Algorithm (HESA).

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1
Department of Medicine, Hepatology Neurobehavioral Research Program, UCSD Liver Center, University of California, 200 West Arbor Drive, San Diego, CA 92108-8707, USA. thassanein@ucsd.edu

Abstract

A primary obstacle to early diagnosis and treatment of hepatic encephalopathy (HE) is the lack of a well-validated, standardized assessment method. The purpose of this study was to present preliminary validity data on a new method of grading HE, the Hepatic Encephalopathy Scoring Algorithm (HESA), which combines clinical impressions with neuropsychological performances to characterize HE. Participants were 49 inpatients admitted for complications of end stage liver disease. Each participant's level of HE was graded using HESA and the West Haven Criteria (WHC) by independent raters blinded to each other's rating. A moderately strong association was found between the two grading methods (r = 0.60), and individual HESA clinical and neuropsychological indicators were good discriminators among grades. The results also suggest HESA may be more sensitive to mental status impairment in the middle grades of HE than WHC. These findings suggest HESA holds promise as a multi-method approach to grading all levels of HE.

PMID:
17710551
DOI:
10.1007/s10620-007-9895-0
[Indexed for MEDLINE]
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