Observational studyWorld journal of gastroenterology2017
Natural history of covert hepatic encephalopathy: An observational study of 366 cirrhotic patients.
Observational study in World journal of gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Correlation of ammonia and blood laboratory parameters with hepatic encephalopathy: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Chinese guidelines on management of hepatic encephalopathy in cirrhosis.World journal of gastroenterology · 2019Guideline
- Liver transplantation promotes early neural reorganization in minimal hepatic encephalopathy: a longitudinal resting state fMRI study.Metabolic brain disease · 2026Article
- Covert hepatic encephalopathy in cirrhosis: implications for early diagnosis and appropriate management.Clinical journal of gastroenterology · 2026Review
- Associations of metabolic syndrome with minimal hepatic encephalopathy in patients with cirrhosis and portal hypertension: a retrospective cohort study.Frontiers in behavioral neuroscience · 2026Article
- Chinese Guidelines on the Management of Hepatic Encephalopathy in Cirrhosis (2024).Journal of clinical and translational hepatology · 2025Article
- Hepatic encephalopathy treatment after transjugular intrahepatic portosystemic shunt: a new perspective on the gut microbiota.Frontiers in medicine · 2025Review
- [A nomogram prediction model for individualized prediction of the risk of covert (minimal) hepatic encephalopathy occurrence in patients with liver cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024Article
- [Chinese guidelines on the management of hepatic encephalopathy in cirrhosis (2024)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024Article
- Article
- [Impact of different diagnostic criteria for assessing mild micro-hepatic encephalopathy in liver cirrhosis: an analysis based on a prospective, multicenter, real-world study].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
- Psychometric methods for diagnosing and monitoring minimal hepatic encephalopathy -current validation level and practical use.Metabolic brain disease · 2022Review
- Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy.Scientific reports · 2022Article
- Efficacy of rifaximin against covert hepatic encephalopathy and hyperammonemia in Japanese patients.PloS one · 2022Article
- Hydrogen-producing small intestinal bacterial overgrowth is associated with hepatic encephalopathy and liver function.PloS one · 2022Observational
- EncephalApp Stroop Test for covert hepatic encephalopathy screening in Tunisian cirrhotic patients.F1000Research · 2022Article
- Identification of minimal hepatic encephalopathy based on dynamic functional connectivity.Brain imaging and behavior · 2021Article
- Hepatic encephalopathy: Lessons from preclinical studies.World journal of hepatology · 2019Review
- [Guidelines for the diagnosis and management of hepatic encephalopathy in cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2018Article
- Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo explore the natural history of covert hepatic encephalopathy (CHE) in absence of medication intervention.
methodsConsecutive outpatient cirrhotic patients in a Chinese tertiary care hospital were enrolled and evaluated for CHE diagnosis. They were followed up for a mean of 11.2 ± 1.3 mo. Time to the first cirrhosis-related complications requiring hospitalization, including overt HE (OHE), resolution of CHE and death/transplantation, were compared between CHE and no-CHE patients. Predictors for complication(s) and death/transplantation were also analyzed.
resultsA total of 366 patients (age: 47.2 ± 8.6 years, male: 73.0%) were enrolled. CHE was identified in 131 patients (35.8%). CHE patients had higher rates of death and incidence of complications requiring hospitalization, including OHE, compared to unimpaired patients. Moreover, 17.6% of CHE patients developed OHE, 42.0% suffered persistent CHE, and 19.8% of CHE spontaneously resolved. In CHE patients, serum albumin < 30 g/L (HR = 5.22,
conclusionCHE exacerbates, persists or resolves without medication intervention in clinically stable cirrhosis. Triage of patients based on these predictors will allow for more cost-effect management of CHE.
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