In Romania, minimal hepatic encephalopathy (MHE) is underdiagnosed and undertreated in patients with liver cirrhosis. The psychometric hepatic encephalopathy score (PHES) is recommended as the first-line tool for the diagnosis of MHE.
Aim: To use PHES in a group of Romanian cirrhotic patients and highlight the relationships between demographic and biological factors and tests results.
Materials and methods: Of the 148 patients with liver cirrhosis admitted to the Iaşi Institute of Gastroenterology and Hepatology between August 2014 and February 2015 only 80 who met the eligibility criteria were enrolled and completed the study. Blood samples for routine tests and serum ammonia were collected from all patients on the day of PHES evaluation.
Results: In the study group (n = 80) mean age was 57.7 ± 8.5 years, and the average number of years of education was 11.2 ± 2.7. The main causes of cirrhosis were alcohol consumption (31 patients--38.8%), hepatitis C virus infection (29 patients--36.3%) and hepatitis B virus infection (17 patients--21.3%). Age, number of years of education, severity of liver disease (measured by using Child-Pugh and MELD scores) and some biological constants (albumin, bilirubin, International Normalized Ratio-INR) were significantly correlated (p < 0.05) with most psychometric tests.
Conclusions: PHES is a practical, objective and useful method for the diagnosis of MHE. Demographic and biological factors correlated with the results of the psychometric test. The PHES requires standardization before applying it in Romanian cirrhotic patients.