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The Importance of Screening Patients With Chronic Liver Disease for Hepatic Encephalopathy

Chronic liver disease (CLD)

  • Affects an estimated 4.5 million people in the United States1
  • 6th leading cause of death in persons aged 25-442
  • 5th leading cause of death in persons aged 45-642

Common types of CLD in the United States are increasing:

Non-alcoholic fatty liver disease (NAFLD) and resulting non-alcoholic steatohepatitis (NASH) are forecasted to increase 21% and 63%, respectively, between 2015 and 2030 due to high rates of diabetes and obesity.*3

Decompensated cirrhosis may increase 168% by 2030, while hepatocellular carcinoma will increase by 137%.*3

As the prevalence of cirrhosis rises, it is expected that cirrhosis complications, including hepatic encephalopathy (HE), will also rise.

The prevalence of minimal or covert HE (CHE) occurs in as many as 50% of patients with CLD, so guidelines recommend every CLD patient be screened.4

Overt HE (OHE) is estimated to occur in up to 30% to 40% of patients with cirrhosis.4

Screening for CHE is important because it can prognosticate OHE development, indicate poor quality of life, and help identify patients and caregivers who may need to be counseled about the disease.4

HE affects the patient, the patient’s family, and everyone the patient comes in contact with. HE affects the patient’s ability to work and drive, and increases health care costs. It is important to recognize and treat HE to improve these conditions.5

*These statistics are based on projections and actual prevalence may differ.

LIVERHEALTHNOW has resources to support you as you screen CLD patients for HE, with tools for providers and companion patient and caregiver tools to educate patients through screening and diagnosis of HE.

You can add your organization logo to the resources and create favorite links of the tools.

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Screening Tools for the Provider

  • Assess HE With the Stroop Test
  • West Haven Criteria
  • Diagnosing Hepatic Encephalopathy in Patients With Liver Disease
  • Cirrhosis and Its Complications

Tools for the Patient

  • What Is Hepatic Encephalopathy?
  • Medication Information for Patients With Hepatic Encephalopathy and Their Caregivers
  • Lifestyle Self-management for Patients With Overt Hepatic Encephalopathy
  • Symptoms, Complications, and Management of Cirrhosis
  • Stages and Types of Liver Disease
References
  1. Chronic Liver Disease Foundation. About CLDF/Mission Statement. https://www.chronicliverdisease.org/about/mission.cfm. Accessed December 12, 2019.
  2. National Center for Health Statistics. Health, United States, 2017. Hyattsville, MD. 2018.
  3. Estes C, Razavi H, Loomba R, et al. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology. 2018;67(1):123-133.
  4. Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014;60(2):715-735.
  5. Patidar KR, Bajaj JS. Covert and overt hepatic encephalopathy: diagnosis and management. Clin Gastroenterol Hepatol. 2015;13(12):2048-2061.