Prevalence of minimal hepatic encephalopathy and quality of life evaluations in hospitalized cirrhotic patients in China.
OBJECTIVE
To investigate the prevalence of minimal hepatic encephalopathy (MHE) and to assess corresponding health-related quality of life (HRQoL) in hospitalized cirrhotic patients in China.


METHODS
This multi-center cross-sectional study included 16 teaching hospitals, which were members of "Hepatobiliary Cooperation Group, Society of Gastroenterology, Chinese Medical Association", from different areas of China carried out between June and October in 2011. All the eligible hospitalized cirrhotic patients (n = 538) were required to complete triplicate number connection tests combined with one digit symbol test for diagnosing MHE. Patients' clinical examination data were complemented by a modified questionnaire assessing HRQoL. Written informed consent was obtained from each patient.


RESULTS
Male was predominant (68.6%) in 519 patients who met the criteria of the study, with a mean age of 49.17 ± 11.02 years. The most common cause of liver cirrhosis was chronic hepatitis B (55.9%). The prevalence of MHE was 39.9% and varied by Child-Pugh-Classification score (CPC-A: 24.8%, CPC-B: 39.4% and CPC-C: 56.1%, P < 0.01). MHE (P < 0.01) and higher CPC scores (P < 0.01) were associated with a high HRQoL scores (reflecting poorer quality of life). The prevalence of MHE was proportionate to CPC (P = 0.01) and high quality of life scores (P = 0.01).


CONCLUSIONS
Hospitalized cirrhotic patients have a high prevalence of MHE that is proportionate to the degree of liver function and HRQoL impairment.
Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Center of Clinical Epidemiology and Evidence-based Medicine, Fudan University, Shanghai 200032, China. wang.jiyao@zs-hospital.sh.cn
Ji-Yao
JY
Wang
Ning-Ping
NP
Zhang
Bao-Rong
BR
Chi
Yu-Qing
YQ
Mi
Li-Na
LN
Meng
Ying-Di
YD
Liu
Jiang-Bin
JB
Wang
Hai-Xing
HX
Jiang
Jin-Hui
JH
Yang
Yun
Y
Xu
Xiao
X
Li
Jian-Ming
JM
Xu
Guo
G
Zhang
Xin-Min
XM
Zhou
Yu-Zheng
YZ
Zhuge
De-An
DA
Tian
Jin
J
Ye
Yu-Lan
YL
Liu
D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006501:Hepatic Encephalopathy / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D006760:Hospitalization; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D011795:Surveys and Questionnaires
Child-Pugh Classification; China; Health-related quality of life; Liver cirrhosis; Minimal hepatic encephalopathy