Falls and cognitive dysfunction impair health-related quality of life in patients with cirrhosis

Román, Eva; Córdoba, Juan; Torrens, M.; Guarner, Carlos; Soriano, Germán

doi:10.1097/meg.0b013e3283589f49

Cited by 57 publications

(63 citation statements)

References 53 publications

(27 reference statements)

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“…Indeed, in refractory ascites, low serum sodium levels correlate with mortality and can be used as a criterion for liver transplantation [75,76]. Additionally, a low serum sodium concentration is also associated with survival in the post-transplantation period and with a number of other clinical consequences, such as falls or cognitive dysfunction [77,78]. Some prognostic scores that incorporate serum sodium levels, such as the Model for End-Stage Liver Disease (MELD)-Na score or the MELD to sodium ratio (MESO) score, have been shown to exhibit a good prognostic ability of mortality in populations that include patients with cirrhosis, chronic HCV/HBV, alcoholic liver disease and especially patients awaiting liver transplantation [79][80][81][82][83][84][85][86][87].…”

Section: Clinical Implications Of Hyponatremia In Patients With Livermentioning

confidence: 99%

Hyponatremia in patients with liver diseases: not just a cirrhosis-induced hemodynamic compromise

et al. 2016

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Hyponatremia (Na(+) <135 mmol/l) is the most common electrolyte disorder. Cirrhosis represents a rather frequent cause of hyponatremia mainly due to systemic and splanchnic vasodilation resulting in decreased effective arterial blood volume, which leads to excessive non-osmotic secretion of antidiuretic hormone. However, hyponatremia of multifactorial origin may be seen in patients with liver diseases. The review focuses on the factors and pathogenetic mechanisms of decreased sodium levels other than the hemodynamic compromise of cirrhosis in patients with liver diseases. The mechanisms and causal or contributing role of pseudohyponatremia, hyperglycemia, infections, drugs and toxins as well as of endocrine disorders, renal failure and cardiac disease in patients with liver disease are meticulously discussed. Hyponatremia of multifactorial origin is frequently observed in patients with liver diseases, and special efforts should be made to delineate the underlying causative and precipitating factors as well as the risk factors of the osmotic demyelination syndrome in order to properly manage this serious electrolyte disorder and avoid treatment pitfalls.

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Section: Clinical Implications Of Hyponatremia In Patients With Livermentioning

confidence: 99%

Hyponatremia in patients with liver diseases: not just a cirrhosis-induced hemodynamic compromise

et al. 2016

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“…Román et al [22] observed significant differences in all categories of the SF-36 except for bodily pain between cirrhotic patients with (n = 78) and without (n = 40) cognitive dysfunction as diagnosed using the PHES battery. Patients without cognitive dysfunction scored within the same range as the healthy reference population, while patients with cognitive dysfunction scored significantly worse.…”

Section: Effect Of Mhe On Daily Living Activitiesmentioning

confidence: 99%

“…While about one third of the mHE patients without psychoactive medication had suffered falls, it was more than two thirds in those on psychoactive medication [23]. In their 2013 study, Román et al [22] also analyzed the relationship between falls and health-related quality of life. Twenty-four patients had a history of falls within the year before examination, and they also scored significantly worse in every category of health-related quality of life than those without falls.…”

Section: Effect Of Mhe On Daily Living Activitiesmentioning

confidence: 99%

The Clinical Relevance of Minimal Hepatic Encephalopathy - A Critical Look

Weißenborn¹

2015

Dig Dis

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Minimal hepatic encephalopathy (mHE) is diagnosed in patients with severe liver disease but no clinical symptoms of encephalopathy if either neuropsychological or neurophysiological tests indicate cerebral dysfunction and other possible causes of brain dysfunction have been excluded. mHE is characterized by deficits in attention, visuospatial orientation, visuoconstructive abilities and motor function. Accordingly, mHE can be expected to interfere with a subject's working ability, especially in those occupations that require handiwork, and driving ability. Indeed, about 60% of blue-collar workers with mHE have been shown to be assessed as unfit for work compared to only 20% of white-collar workers, and about 50% of patients with mHE have been judged unfit to drive a car in several studies. mHE interferes with a patient's quality of life and is associated with an increased risk of developing overt HE as well as increased mortality. Whether mHE is of importance for cognitive function after liver transplantation has still to be clarified.

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“…Finally, it was recently recognized that HE is associated with falls; if this is caused by cognitive or motor abnormalities or by their combination, or even by cirrhosis per se, is not yet clear [15,16].…”

Section: Clinical Manifestationmentioning

confidence: 99%