title: Hepatic encephalopathy in patients with non-cirrhotic portal hypertension: Description, prevalence and risk factors.
abstract: BACKGROUND
  Hepatic encephalopathy (HE) is a common complication of cirrhosis but it is less studied in patients with non-cirrhotic portal hypertension (NCPH).
  
  
  OBJECTIVE
  To describe the prevalence of cognitive impairment (overt and covert HE) in NCPH patients and to identify the risk factors for its development.
  
  
  METHODS
  51 patients with NCPH, 35 with chronic portal vein thrombosis (PVT) and 16 with idiopathic non-cirrhotic portal hypertension (INCPH), were evaluated for the presence of previous or present overt HE (OHE). The psychometric hepatic encephalopathy score and the SCAN battery were used to detect the presence of covert HE (CHE). 34 compensated cirrhotic patients were used as control. In NCPH patients, abdominal scans were performed to detect the presence of shunts.
  
  
  RESULTS
  None of the patients experienced OHE at evaluation while 5.7% of PVT and 12.5% of INCPH patients referred at least one documented episode of previous OHE, similarly to patients with cirrhosis (14.7%). Even if lower than in patients with cirrhosis (64.7%), a considerable proportion of patients with chronic PVT (34.3%) and INCPH (25%) had CHE (p=0.008). The presence of a large portal-systemic shunt was the only factor significantly correlated to cognitive impairment in NCPH patients.
  
  
  CONCLUSIONS
  HE is a tangible complication of NCPH and is mainly related to the presence of portal-systemic shunts.
authors.affiliation: Department of Clinical Medicine, Center for the Diagnosis and Treatment of Portal Hypertension, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Nicoletti
authors.affiliation: Department of Clinical Medicine, Center for the Diagnosis and Treatment of Portal Hypertension, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Gioia
authors.affiliation: Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-pathological Sciences, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Pierleone
authors.initials: P
authors.lastname: Lucatelli
authors.affiliation: Department of Clinical Medicine, Center for the Diagnosis and Treatment of Portal Hypertension, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Nardelli
authors.affiliation: Department of Clinical Medicine, Center for the Diagnosis and Treatment of Portal Hypertension, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Pasquale
authors.affiliation: Department of Clinical Medicine, Center for the Diagnosis and Treatment of Portal Hypertension, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Nogas Sobrinho
authors.affiliation: Department of Clinical Medicine, Center for the Diagnosis and Treatment of Portal Hypertension, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Pentassuglio
authors.affiliation: Department of Clinical Medicine, Center for the Diagnosis and Treatment of Portal Hypertension, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Greco
authors.affiliation: Department of Clinical Medicine, Center for the Diagnosis and Treatment of Portal Hypertension, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Adriano
authors.initials: A
authors.lastname: De Santis
authors.affiliation: Department of Clinical Medicine, Center for the Diagnosis and Treatment of Portal Hypertension, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Merli
authors.affiliation: Department of Clinical Medicine, Center for the Diagnosis and Treatment of Portal Hypertension, "Sapienza" University of Rome, Rome, Italy. Electronic address: oliviero.riggio@uniroma1.it.
authors.forename: Oliviero
authors.initials: O
authors.lastname: Riggio
mesh_terms: D000328:Adult; D000368:Aged; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000601:surgery; D007558:Italy; D008297:Male; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology; D011594:Psychometrics; D012307:Risk Factors; D020246:Venous Thrombosis / Q000453:epidemiology
keywords: Hepatic encephalopathy; Non-cirrhotic portal hypertension; Portal-systemic shunt