Psychometric Hepatic Encephalopathy Score for the detection of minimal hepatic encephalopathy in Korean patients with liver cirrhosis

Background and Aim: Although the Psychometric Hepatic Encephalopathy Score (PHES) for the diagnosis of minimal hepatic encephalopathy (MHE) has been validated in several countries, further validation is required for its use in different populations. The aims of this study were thus to standardize the PHES in a healthy Korean population and evaluate the prevalence of MHE among Korean patients with liver cirrhosis. Methods: Two-hundred healthy subjects without evidence of liver disease and 160 patients with liver cirrhosis without overt HE were included. Blood sampling for routine laboratory tests and determination of venous ammonia concentration was performed on the day of PHES neuropsychological testing. Results: The age and education years of the control group were 41 +/- 13 years and 13 +/- 3 years, respectively; 100 of the subjects (50.0%) were men. The PHES for the control group was -0.31 +/- 2.06 and the normal range was thus set at > -5 points. The age and education years of the liver cirrhosis group were 55 +/- 8 and 11 +/- 4 years, respectively; 102 of those in this group (63.8%) were men. Of the liver cirrhosis patients, 129 (80.6%), 21 (13.1%), and 10 (6.3%) had ChildPugh grades A, B, and C, respectively. The PHES of the liver cirrhosis group was -2.94 +/- 3.39. MHE was diagnosed in 41 patients (25.6%), of which 26 (20.2%), nine (42.9%), and six (60.0%) had ChildPugh grades A, B, and C, respectively. Conclusions: The PHES was useful for detecting patients with MHE. A significant proportion of Korean patients with liver cirrhosis suffer from MHE.