Hepatic encephalopathy: classification and treatment

Hepatic encephalopathy (HE) is a major complication of liver disease that has a multi-faceted pathophysiology. [1] Stepanova M. Mishra A. Venkatesan C. Younossi Z.M. In-hospital mortality and economic burden associated with hepatic encephalopathy in the United States from 2005 to 2009. Clin Gastroenterol Hepatol. 2012; 10 ([e1031]): 1034-1041 Abstract Full Text Full Text PDF PubMed Scopus (182) Google Scholar It is associated with a substantial burden to the individual, their caregivers, society and the overall healthcare system. The emergence of HE as a leading cause of re-admissions, mortality and psychosocial impairment in cirrhosis should be a rallying cry to improve its management. [2] Bajaj J.S. Reddy K.R. Tandon P. Wong F. Kamath P.S. Garcia-Tsao G. et al. The 3-month readmission rate remains unacceptably high in a large North American cohort of patients with cirrhosis. Hepatology. 2016; 64: 200-208 Crossref PubMed Scopus (161) Google Scholar The current demographic trend towards an aging population makes diagnosis challenging and increases the burden of HE, since most older patients are not liver transplant candidates.