Background and objective: Minimal hepatic encephalopathy (MHE) induces an impairment in the quality of life and has been found as the first stage in hepatic encephalopathy syndrome. Psychometric Hepatic Encephalopathy Score (PHES) is a psychometric test battery widely utilized in the diagnosis of MHE which requires correction by age and education.
Population and method: Eight-hundred and eighty four healthy people were included. Trailmaking test-A (TMT-A), TMT-B, digit symbol test (DST), serial dotting (SDT) and line drawing test (LDT) were performed. Age, education, gender, alcohol consumption and hospitalization were recorded. T-student and Pearson correlation were utilized in univariate analyses. A multiple linear regression was performed to detect independent variables associated with psychometric test score. Using the equation from the multiple linear regression, normality tables were built.
Results: Age and education were associated with all 5 tests. An alcohol consumption higher than 10 g per day was associated with a lower score in DST and SDT. A gender influence was seen in TMT-A and TMT-B. Moreover, some differences were found in SDT, TMT-B and LDT according to hospital procedence. In multivariate analyses using multiple linear regression, age and education were independently associated with all five tests.
Conclusions: Normality tables of the PHES allow investigating MHE in cirrhotics avoiding local control groups. Taking in mind normality tables, PHES could become a gold standard test to analyze further diagnostic methods and to evaluate drugs efficacy in MHE. Normality tables are freely available at http://www.redEH.org.