PHES scores have limited impact on the risk of overt HE in patients with minimal HE

Simon Johannes Gairing; Chiara Mangini; Lisa Zarantonello; Elise Jonasson; Sven Danneberg; Philippe Sultanik; Peter Robert Galle; Stefania Gioia; Joachim Labenz; Anna S Lok; Jens Uwe Marquardt; Mette Munk Lauridsen; Patricia P Bloom; Dominique Thabut; Silvia Nardelli; Sara Montagnese; Christian Labenz

doi:10.1097/HC9.0000000000000438

PHES scores have limited impact on the risk of overt HE in patients with minimal HE

Hepatol Commun. 2024 May 3;8(5):e0438. doi: 10.1097/HC9.0000000000000438. eCollection 2024 May 1.

Authors

Simon Johannes Gairing^{1

2}, Chiara Mangini³, Lisa Zarantonello³, Elise Jonasson⁴, Sven Danneberg⁵, Philippe Sultanik⁶, Peter Robert Galle^{1

2}, Stefania Gioia⁷, Joachim Labenz⁸, Anna S Lok⁹, Jens Uwe Marquardt⁵, Mette Munk Lauridsen⁴, Patricia P Bloom⁹, Dominique Thabut⁶, Silvia Nardelli⁷, Sara Montagnese^{3

10}, Christian Labenz^{1

2}

Affiliations

¹ Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
² Cirrhosis Center Mainz (CCM), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
³ Department of Medicine, University of Padova, Padova, Italy.
⁴ Department of Gastroenterology and Hepatology, Hospital of South West Jutland, Esbjerg, Denmark.
⁵ Department of Medicine I, University Hospital Schleswig-Holstein, Lübeck, Germany.
⁶ Service d'hépato-gastroentérologie, Sorbonne Université, Hôpital Pitié-Salpêtrière Assistance Publique Hôpitaux de Paris, Paris, France.
⁷ Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
⁸ Department of Medicine, Diakonie Hospital Jung-Stilling, Siegen, Germany.
⁹ Department of Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA.
¹⁰ Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.

Abstract

Background: Minimal hepatic encephalopathy, defined by the portosystemic hepatic encephalopathy score (PHES), is associated with a higher risk of subsequent OHE. It remains unclear if there is a stepwise increase in OHE risk with worse PHES results.

Methods: In this multicenter study, patients with minimal hepatic encephalopathy, as defined by abnormal PHES, were followed for OHE development.

Results: In all, 207 patients were included. There was no stepwise increase in OHE risk with worse PHES results.

Conclusions: Abnormal PHES is associated with a higher OHE risk, but we found no stepwise increase in OHE risk with worse PHES results below the established cutoff.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Female
Hepatic Encephalopathy* / etiology
Humans
Male
Middle Aged
Risk Assessment
Risk Factors
Severity of Illness Index