The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors.
Abstract Details
Predicting hepatic encephalopathy in patients with cirrhosis: A UK population-based study and validation of risk scores
Hepatol Commun. 2023 Nov 6;7(11):e0307. doi: 10.1097/HC9.0000000000000307.eCollection 2023 Nov 1.
1Global Pharmacoepidemiology, Human Data Sciences, Cardiff, UK.
2Market Access and Government Affairs, Norgine Pharmaceuticals Limited, Uxbridge, UK.
3Gwent Liver Unit, Hepatology Department, University Hospitals Bristol and Weston, Bristol, UK.
4Gwent Liver Unit, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, Wales, UK.
5Institute of Population Health, School of Medicine, Cardiff University, Cardiff, UK.
Abstract
Background: HE is a common neurologic complication in cirrhosis associated with substantial disease and economic burden. HE symptoms are nonspecific and there are limited ways of identifying patients with cirrhosis at high risk of later developing HE. A risk score was previously developed to identify patients at risk of developing HE in a predominately male US cohort. Here, we evaluated the performance of the HE risk scores in a UK cohort study.
Methods: Health care records from Clinical Practice Research Datalink and linked Hospital Episode Statistics were used to select patients with cirrhosis who were diagnosed with HE, confirmed by a diagnosis code for HE or a rifaximin-α prescription. The index date was the date of incident cirrhosis. The study period was from January 2003 to June 2019.
Results: A total of 40,809 patients with cirrhosis were selected in the UK cohort, of whom 59% were male. A total of 1561 patients were diagnosed with HE. Applying the UK cohort to the baseline sensitivity risk cutoff (≥-11) from the US cohort provided a sensitivity of 92% and a negative predictive value of 99%. Within a longitudinal model, applying a sensitivity cutoff of ≥-3 to this cohort gave a sensitivity of 89% and a negative predictive value of 99%.
Conclusions: Using data from the UK, the previously developed HE risk scores were found to be reliable for selecting those most likely to progress to HE in patients with liver cirrhosis. Despite the HE risk scores originally being estimated using the data from a predominately male US cohort, the scores were validated and found to be generalizable to female patients.
Stay Informed!
