P: 27 Evaluation of Neurocognitive Function in Patients With Compensated and Decompensed Cirrhosis

Abstract

BACKGROUND: Cirrhosis is the end result of chronic liver damage caused by multiple entities. Up to 20%–60% of patients with cirrhosis are affected by a peculiar type of mild cognitive impairment related to selective attention and executive functions, visuomotor capacity, psychomotor speed, inhibition of response and selection of response that can only be detected by psychometry. METHODS: An observational, cross-sectional, analytical study was carried out. A total sample of 126 patients was established, 64 patients for each group. The NeuroPsi instrument was applied to determine the domains (Orientation, Attention, Visual Episodic Memory, Verbal Episodic Memory, Language, Reading Writing, Executive Conceptual Functions and Executive Motor Functions); With the transcranial Doppler, the hemodynamic parameters such as velocity, pulsatility index, resistance index, as well as the apnea index to assess cerebral vasoreactivity were evaluated. RESULTS: Up to now, 55 patients were studied, two groups were established: compensated cirrhotic 18 and decompensated, the gender ratio was 38% men and 62% women, with a median of 60 years. Compensated cirrhotics showed a higher percentage of patients without hepatic encephalopathy (HE) 65% vs 27.1%. The mean Child Pugh score was 7.47 ± 1.82. MELD Na mean for total patients was 12.98 ± 5.04. Of the masters, Reading Writing with 4.50 ± 0.89 for compensated and 4.85 ± 0.50 in decompensated (P = 0.07); in the domain of Executive Motor Functions with 5.69 ± 1.8 for compensated and 6.24 ± 0.89 decompensated (P = 0.16). CONCLUSIONS: This study could not find significant differences in the averages obtained in the 8 cognitive domains explored, between the compensated and decompensated cirrhotic patients, nor correlation between the Child Pugh score and the performance in the cognitive tests; It is considered relevant to increase the sample of this study to have more solid evidence. In the cerebral hemodynamic parameters assessed by transcranial Doppler, there were no significant differences between compensated and decompensated patients.