Prevalence and risk factors of covert hepatic encephalopathy in cirrhotic patients: A multicenter study in China

作者全名："Zeng, Xin; Yin, Chuan; Sun, Chun Yan; Lu, Cui Hua; Zhao, Shou Song; Gao, Xiao Hong; Chen, Dong Feng; Wen, Liang Zhi; Lin, Shi De; Yang, Ping; Zhang, Qian Hua; Guan, Yu Juan; Zhang, Yang; Ren, Shu Qin; Cai, Da Chuan; Zhang, Jie; Li, Lei; Chang, Cong Ying; Zhou, Xiao Lin; Shi, Pei Mei; Chen, Shi Yao; Lin, Yong; Xie, Wei Fen"

作者地址："[Zeng, Xin; Sun, Chun Yan] Tongji Univ, Shanghai East Hosp, Dept Gastroenterol, Shanghai, Peoples R China; [Yin, Chuan; Shi, Pei Mei; Lin, Yong; Xie, Wei Fen] Navy Med Univ, Changzheng Hosp, Dept Gastroenterol, Shanghai, Peoples R China; [Lu, Cui Hua] Nantong Univ, Affiliated Hosp, Dept Gastroenterol, Nantong, Jiangsu, Peoples R China; [Zhao, Shou Song] First Affiliated Hosp, Bengbu Med Coll, Dept Infect Dis, Bengbu, Anhui, Peoples R China; [Gao, Xiao Hong] Yanan Univ, Affiliated Hosp, Dept Infect Dis, Yanan, Shaanxi, Peoples R China; [Chen, Dong Feng; Wen, Liang Zhi] Army Med Univ, Mil Med Univ 3, Daping Hosp, Dept Gastroenterol,Chongqing Key Lab Digest Malign, Chongqing, Peoples R China; [Lin, Shi De; Yang, Ping] Zunyi Med Univ, Affiliated Hosp, Dept Infect Dis, Zunyi, Guizhou, Peoples R China; [Zhang, Qian Hua] Zhongshan Second Peoples Hosp, Dept Infect Dis, Zhongshan, Guangdong, Peoples R China; [Guan, Yu Juan] Guangzhou Med Univ, Guangzhou Peoples Hosp 8, Dept Hepatol, Guangzhou, Guangdong, Peoples R China; [Zhang, Yang; Ren, Shu Qin] Nucl Ind Hosp 416, Affiliated Hosp 2, Chengdu Med Coll, Dept Gastroenterol, Chengdu, Sichuan, Peoples R China; [Cai, Da Chuan] Chongqing Med Univ, Affiliated Hosp 2, Dept Infect Dis, Chongqing, Peoples R China; [Zhang, Jie] Taiyuan 3 Hosp, Dept Infect Liver Dis & Oncol, Taiyuan, Shanxi, Peoples R China; [Li, Lei] Univ Sci & Technol China, Affiliated Hosp 1, Dept Infect Dis, Hefei, Anhui, Peoples R China; [Chang, Cong Ying] Second Hosp Xingtai, Dept Hepatol, Xingtai, Hebei, Peoples R China; [Zhou, Xiao Lin] Yichang Cent Peoples Hosp, Dept Gastroenterol, Yichang, Hubei, Peoples R China; [Chen, Shi Yao] Fudan Univ, Zhongshan Hosp, Dept Gastroenterol & Hepatol, Shanghai, Peoples R China; [Chen, Shi Yao] Fudan Univ, Zhongshan Hosp, Dept Gastroenterol & Hepatol, 180 Fenglin Rd, Shanghai 200032, Peoples R China; [Lin, Yong; Xie, Wei Fen] Navy Med Univ, Changzheng Hosp, Dept Gastroenterol, 415 Fengyang Rd, Shanghai 200003, Peoples R China"

通信作者："Chen, SY (通讯作者)，Fudan Univ, Zhongshan Hosp, Dept Gastroenterol & Hepatol, 180 Fenglin Rd, Shanghai 200032, Peoples R China.; Lin, Y; Xie, WF (通讯作者)，Navy Med Univ, Changzheng Hosp, Dept Gastroenterol, 415 Fengyang Rd, Shanghai 200003, Peoples R China."

来源：JOURNAL OF DIGESTIVE DISEASES

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000986762100001

JCR分区：Q3

影响因子：2.3

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：cognitive dysfunction; covert hepatic encephalopathy; health-related quality of life; psychometric hepatic encephalopathy score; Stroop test

摘要："ObjectiveWe aimed to investigate the prevalence of covert hepatic encephalopathy (CHE) in cirrhotic patients in China and its risk factors.MethodsA multicenter prospective observational study was conducted from January 2021 to March 2022 at 16 medical centers across China to investigate the risk factors of CHE and establish a prediction model for CHE episodes.ResultsA total of 528 patients were enrolled in the study. Based on both the psychometric hepatic encephalopathy score and Stroop test results, the prevalence of CHE was 50.4% (266/528), and the consistency between these two tests was 68.9%. Multivariate analysis showed that age (odds ratio [OR] 1.043, 95% confidence interval [CI] 1.022-1.063, P < 0.001), duration of education (OR 0.891, 95% CI 0.832-0.954, P = 0.001), comorbidities of cardiovascular diseases, hypertension, cerebral apoplexy or diabetes mellitus (OR 2.072, 95% CI 1.370-3.133, P < 0.001), Child-Pugh score (OR 1.142, 95% CI 1.029-1.465, P = 0.025), and blood urea nitrogen concentration (OR 1.126, 95% CI 1.038-1.221, P = 0.004) were associated with CHE episodes. According to the Chronic Liver Disease Questionnaire, CHE patients had lower scores for abdominal symptoms and systemic symptoms (P < 0.001), indicating a poor health-related quality of life. Based on a stepwise Cox regression hazard model, we established a nomogram for determining the probabilities of CHE episodes, and the area under the receiver operating characteristic curve was 0.733 (95% CI 0.679-0.788) and 0.713 (95% CI 0.628-0.797) in the training and validation cohorts.ConclusionsCHE is a common complication of cirrhosis in China. Large-scale studies with long-term follow-up are needed to determine the natural history of Chinese CHE patients."

基金机构：Medical Innovation Research Project of Shanghai Science and Technology Commission [22Y11908400]; Outstanding Youth Medical Talents Project of Shanghai "Rising Stars of Medical Talent" Youth Development Program [SHWSRS2021-99]; Pilot Talent Plan of Shanghai East Hospital [2019lhrcjh]; Talent Plan of Shanghai Municipal Health Commission for Academic Leader [2022XD028]

基金资助正文："Medical Innovation Research Project of Shanghai Science and Technology Commission, Grant/Award Number: 22Y11908400; Outstanding Youth Medical Talents Project of Shanghai ""Rising Stars of Medical Talent"" Youth Development Program, Grant/Award Number: SHWSRS2021-99; Pilot Talent Plan of Shanghai East Hospital, Grant/Award Number: 2019lhrcjh; Talent Plan of Shanghai Municipal Health Commission for Academic Leader, Grant/Award Number: 2022XD028"