Epidemiology

Hepatic encephalopathy increases falls in cirrhotic patients

Last Updated: 2010-11-26 9:00:47 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Minimal hepatic encephalopathy (MHE) increases the risk of falls in patients with cirrhosis, Spanish researchers report in an October 26th online paper in the American Journal of Gastroenterology.

"MHE causes a decline in cognitive function and impairs the ability to perform daily activities in patients with cirrhosis," Dr. Germ�n Soriano, senior author on the study, told Reuters Health by email. "In the present study involving 130 cirrhotic patients and 43 controls, previous falls were more frequent in patients with MHE than in those without MHE and controls."

Dr. Soriano of Hospital de la Santa Creu i Sant Pau, Barcelona, and colleagues note that MHE can only be detected by psychometric or neurophysiological testing and is present in a variable proportion of patients depending on the populations studied and the criteria used for diagnosis.

In the current study, of the 130 patients, 34.6% exhibited MHE and of this group, 40% reported falls in the previous 12 months. This was true of only 12.9% of those without MHE and 11.6% of controls. In the MHE group, falls led to a greater need for primary health care services (8.8% versus none).

In the subset of 21 patients on psychoactive drugs, 75% with MHE reported falls compared to only 15.3% of those without the condition.

Independent risk factors associated with previous falls were MHE (odds ratio, 2.91), previous encephalopathy (odds ratio, 2.87) and antidepressant therapy (odds ratio, 3.91).

The researchers concede that the study was retrospective, but observe that in light of these findings future prospective studies are warranted. In particular, Dr. Soriano added, "Falls represented a significant cause for healthcare and hospitalization requirements in these patients."

SOURCE: http://link.reuters.com/map66q

Am J Gastroenterol 2010.