Minimal hepatic encephalopathy does not impair health-related quality of life in patients with cirrhosis: a prospective study


Ewa Wunsch, MD, Liver Unit, Pomeranian Medical University, Al. Powstancow Wlkp. 72, 70-111 Szczecin, Poland
Tel: +48 91 466 14 90
Fax: +48 91 466 14 92


Background: Minimal hepatic encephalopathy (HE) is a serious complication of cirrhosis; however, the impact of minimal HE on health-related quality of life (HRQoL) remains controversial. The Psychometric Hepatic Encephalopathy Score (PHES) remains a ‘gold standard’ for the assessment of minimal HE, but its results clearly differ between studied populations.

Aim: We studied the effect of minimal HE on patient HRQoL.

Methods: Eighty-seven consecutive cirrhotic patients were included. All patients underwent clinical and psychometric evaluation at the same day. Ten subjects with overt HE confirmed with West Haven criteria were excluded from the study, thus 77 patients were finally analysed. Patients with minimal HE were identified on the grounds of altered PHES. HRQoL was assessed by the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and the Chronic Liver Disease Questionnaire (CLDQ). Normative reference data for PHES were established from a cohort of 305 healthy Polish subjects.

Results: Twenty-nine (37.7%) patients were diagnosed with minimal HE. When patients with and without minimal HE were compared, HRQoL was not significantly different in none of the SF-36 and CLDQ domains.

Conclusion: Minimal HE does not affect HRQoL.