ArticlePloS one2022
A simple covert hepatic encephalopathy screening model based on blood biochemical parameters in patients with cirrhosis.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Risk prediction models for hepatic encephalopathy in patients with liver cirrhosis: a systematic review and meta-analysis.BMC gastroenterology · 2026Pooled it
- Covert hepatic encephalopathy as a multi-organ syndrome: the gut-liver-muscle-brain axis, diagnosis, treatment, and multidisciplinary care.Journal of gastroenterology · 2026Review
- Impact of simulation settings, time-activity curve integration range, and imaging time points on full Monte Carlo-basedAnnals of nuclear medicine · 2026Article
- Covert hepatic encephalopathy in cirrhosis: implications for early diagnosis and appropriate management.Clinical journal of gastroenterology · 2026Review
- Usefulness of the Stroop test in predicting decompensation events in patients with cirrhosis: A prospective cohort study.Scientific reports · 2026Article
- Frailty Diagnosed With the Clinical Frailty Scale Stratifies the Risk of Covert and Overt Hepatic Encephalopathy in Patients With Cirrhosis.JGH open : an open access journal of gastroenterology and hepatology · 2026Article
- Development of overt hepatic encephalopathy increases mortality in patients with cirrhosis: a multicenter retrospective cohort study.Journal of gastroenterology · 2026Article
- Correlation of Serum Zinc Levels with Hepatic Encephalopathy Severity in Patients with Decompensated Liver Cirrhosis: A Prospective Observational Study from Egypt.Biological trace element research · 2025Observational
- Simple scoring model for predicting overt hepatic encephalopathy in geriatric cirrhosis: A multicenter retrospective cohort study.Metabolic brain disease · 2025Article
- Current management and future perspectives of covert hepatic encephalopathy in Japan: a nationwide survey.Journal of gastroenterology · 2025Article
- Benefits of Liver Volume and Serum Zinc Level Assessment for the Screening of Covert Hepatic Encephalopathy in Patients with Child-Pugh Class A Cirrhosis.Diagnostics (Basel, Switzerland) · 2024Article
- Hepatic encephalopathy post-TIPS: Current status and prospects in predictive assessment.Computational and structural biotechnology journal · 2024Review
- Evaluation of Quality of Life and Risk Factors in Patients With Covert Hepatic Encephalopathy Including Those With Hepatocellular Carcinoma.Cancer diagnosis & prognosisArticle
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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
aimCovert hepatic encephalopathy (CHE) adversely affects clinical outcomes in patients with liver cirrhosis, although its diagnosis is difficult. This study aimed to establish a simple CHE screening model based on blood-related biochemical parameters.
methodsThis retrospective study enrolled 439 patients who were assessed for CHE using a neuropsychiatric test between January 2011 and June 2019. A simple CHE (sCHE) score was calculated with hypoalbuminemia (≤ 3.5 g/dL) and hyperammonemia (≥ 80 μg/dL) as 1 point each. The association between sCHE score and CHE or overt hepatic encephalopathy (OHE) was assessed using logistic regression and Fine-Gray competing risk regression models.
resultsOf 381 eligible patients, 79 (21%) were diagnosed with CHE. The distribution of sCHE scores was 48% with 0 point, 33% with 1 point, and 19% with 2 points. Patients with sCHE score ≥ 1 point had a higher prevalence of CHE than those with sCHE score of 0 (27% vs. 14%, P = 0.002). A cut-off value of 1 point showed high discriminative ability for identifying CHE, with a sensitivity of 0.67, specificity of 0.56, positive predictive value of 0.27, and negative predictive value of 0.86. During the median follow-up period of 2.2 years, 58 (15%) patients developed OHE. Multivariate analysis showed that sCHE score ≥ 1 (sub-distribution hazard ratio [SHR], 2.69; 95% confidence interval [CI], 1.41-5.15) and CHE (SHR, 2.17; 95% CI, 1.26-3.73) independently predicted OHE.
conclusionsThe sCHE score is a useful screening model for identifying patients with CHE and for predicting OHE occurrence.
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