Prognostic Implications of Minimal/Covert Hepatic Encephalopathy: Large-scale Validation Cohort Studies

Christopher R. Flud, Andres Duarte-Rojo*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations


Minimal or Covert Hepatic Encephalopathy (MHE/CHE), the preclinical phase of Hepatic Encephalopathy (HE), is strongly associated with poorer Quality of Life (QOL), Overt HE (OHE), and death. Several diagnostic tests have been developed that have prognostic value in predicting clinical outcomes such as OHE, cirrhosis progression, and death. However, dispute among clinicians and HE researchers have kept its application largely underutilized. Current issues contributing to the confusion include: lack of a formal definition for CHE, uncertainty of which diagnostic tools to use, and whether one or two abnormal tests are required for a diagnosis. Due to this misunderstanding, the aims of this review were to consolidate large-scale (n ≥ 100) validation studies in order to discuss these obstacles and make recommendations for improving our approach to MHE/CHE. The studies included in this review are a great resource for initiating a unified effort for advancement in HE, and as such, it is our hope that this will drive progress toward common goals that will permanently improve the lives of patients with cirrhosis.

Original languageEnglish (US)
Pages (from-to)112-116
Number of pages5
JournalJournal of Clinical and Experimental Hepatology
Issue number1
StatePublished - Jan 1 2019


  • cirrhosis complications
  • mortality
  • neuropsychometric tests
  • quality of life

ASJC Scopus subject areas

  • Hepatology


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