Abstract
Background and study aim: Hepatic encephalopathy occurs in approximately 30-45% of patients with cirrhosis and 10–50% of patients with transjugular intrahepatic Porto systemic shunt, while minimal hepatic encephalopathy affects approximately 20–60% of patients with liver disease. There are multiple prognostic scores that predict the mortality from chronic liver disease, of which the Child-Pugh score and the Model for End-stage Liver Disease (MELD) score are the most commonly used. The most widely used scale used to evaluate HE is the West-Haven (WH) scale, with scores ranging from 0 to 4. This study is designed to compare Glasgow coma scale to West-Haven scale in prediction of prognosis and survival of patients with hepatic encephalopathy. Patients and Methods: This study was conducted on 100 patients with liver cirrhosis and overt Hepatic Encephalopathy admitted to The Department of Hepatology, Gastroenterology and Infectious Diseases of Mansoura Health Insurance Hospital, divided into four groups according to the grade of encephalopathy by West-Haven Criteria. Results: There was no difference in prediction of survival among the studied patients assessed by GCS, MELD score, uMELD score and Child score (all had the same results). Conclusion: Glasgow Coma Scale can be a prognostic tool for morbidity and mortality, as well as, follow-up in patients with HE
Highlights
Hepatic encephalopathy (HE) is a serious complication of decompensated cirrhosis that manifests as a wide range of neuropsychological clinical findings ranging from minimal HE to coma [1]
Previous studies recommended using clinical scales for grading hepatic encephalopathy and to report efficacy in therapeutic trials such as the WestHaven criteria and Glasgow Coma Scale to assess the severity of HE [3]
Aim of the work: this study aims at assessing the significance of Glasgow coma scale in evaluation of patients with hepatic encephalopathy in comparison
Summary
Hepatic encephalopathy (HE) is a serious complication of decompensated cirrhosis that manifests as a wide range of neuropsychological clinical findings ranging from minimal HE to coma [1]. HE can be classified as either ‘overt’ or ‘minimal’ Overt He (oHE) is a syndrome of neurological and neuronpsychiatric abnormalities that can be detected by bedside clinical tests. Patients with minimal He (mHE) present with normal mental and neurological status upon clinical examination but specific psychometric tests yield abnormal results [2]. Previous studies recommended using clinical scales for grading hepatic encephalopathy and to report efficacy in therapeutic trials such as the WestHaven criteria and Glasgow Coma Scale to assess the severity of HE [3]. This study is designed to compare Glasgow coma scale to West-Haven scale in prediction of prognosis and survival of patients with hepatic encephalopathy
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