Severity of hepatic encephalopathy before liver transplantation is associated with quality of life after transplantation

Tarter, R. E.

doi:10.1001/archinte.152.10.2097

Cited by 26 publications

(26 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The principal psychiatric problems encountered after surgery are organic brain syndrome, depression, and anxiety. [9][10][11][12][13] Mental disorders can also be associated with cyclosporine neurotoxicity and such problems as agitation, insomnia, or loss of energy. 14 Common causes of depression are acute allograft rejection and infections.…”

confidence: 99%

“…14 Common causes of depression are acute allograft rejection and infections. 9,11 Tarter et al 2,12,15 studied psychosocial adjustment after LTX. Using the Nottingham Health Profile in a cross-sectional retrospective survey of 81 patients, Lowe et al 16 reported that their patients showed a QOL similar to that of a general population.…”

confidence: 99%

See 1 more Smart Citation

Health-related quality of life after liver transplantation

Hellgren

Berglund²,

Gunnarsson

et al. 1998

Liver Transpl

View full text Add to dashboard Cite

To gather information regarding how to best assist liver transplant recipients in improving their self-care capacity and well-being, we investigated their total health situation. A retrospective, crosssectional survey with up to a 10-year follow-up concerning experienced health and quality of life after liver transplantation (LTX) was conducted. The aim of this study was to provide descriptive data on the experienced health and health-related quality of life (HRQOL) after LTX and to evaluate whether the pretransplantation medical conditions affected these parameters. All patients who had undergone LTX, were alive at the time of the study, and had a follow-up of more than 6 months (n ‫؍‬ 134) were asked to complete three selfadministered questionnaires. The response rate was 95% (n ‫؍‬ 120). There was no correlation between pretransplantation Child-Pugh score and HRQOL after LTX. Liver transplant recipients were more limited in their physical health than healthy subjects but were equal in social functioning and mental health. Twenty-six percent suffered from severe bodily pain. A significant difference was reported in all health areas, with the exception of vitality and social functioning, between employed and unemployed transplant recipients. Liver transplant recipients suffered from limited physical functioning many years after transplantation. Their social functioning and mental health were not negatively affected. This study emphasizes that bodily pain and difficulties in performing regular activities because of physical illness are problems frequently experienced by liver transplant recipients.

show abstract

confidence: 99%

Health-related quality of life after liver transplantation

Hellgren

Berglund²,

Gunnarsson

et al. 1998

Liver Transpl

View full text Add to dashboard Cite

show abstract

“…HRQOL questionnaires have been used to study the influence of chronic diseases on daily life. [24][25][26][27] The Sickness Impact Profile (SIP) questionnaire, which assesses wide aspects of quality of life, has been used previously to determine the influence of chronic liver disease on patients' daily functioning. 3,[26][27][28] This study was carried out to determine the influence of treatment on psychomotor performance and HRQOL of patients with MHE.…”

mentioning

confidence: 99%

Lactulose improves cognitive functions and health-related quality of life in patients with cirrhosis who have minimal hepatic encephalopathy

et al. 2007

View full text Add to dashboard Cite

Minimal hepatic encephalopathy (MHE) has a negative effect on patients' daily functioning. Thus far, no study has investigated the effect of treatment-related improvement in cognitive functions on health-related quality of life (HRQOL). We measured psychometric performance by number and figure connection tests parts A and B, picture completion, and block design tests and HRQOL by the Sickness Impact Profile (SIP) of 90 patients with cirrhosis on inclusion into the study and 3 months later. A Z score less than ؊2 on the neuropsychological (NP) tests was considered abnormal. Sixty-one (67.7%) patients had MHE. They were randomly assigned in a 1:1 ratio to receive treatment (lactulose) for 3 months (n ‫؍‬ 31) or no treatment (n ‫؍‬ 30) in a nonblinded design. H epatic encephalopathy (HE) is a spectrum of neuropsychiatric abnormalities seen in patients with liver dysfunction diagnosed after exclusion of other known brain diseases. The Working Party at the 11th World Congress of Gastroenterology, Vienna, under the Organization Mondiale de Gastroentrologie proposed a multiaxial definition of HE that defined both the type of hepatic abnormality (type A, B, or C) and the duration and characteristics of neurological manifestations (episodic, persistent, or minimal HE) in chronic liver disease. 1 HE has been considered a continuous dimension that could be measured with 1 index to summarize several neurological domains, such as cognition, emotion, behavior, and biologic rhythms. Minimal hepatic encephalopathy (MHE) represents a portion of this dimension and is the mildest form of HE. Whereas patients with HE have impaired intellectual functioning, personality changes, altered level of consciousness, and neuromuscular dysfunction, patients with MHE have no recognizable clinical symptoms of HE but do have mild cognitive and psychomotor deficits. In the absence of a "gold standard" for determining MHE, neuropsychological (NP) and neurophysiological methods have been the most trusted and widely used tests to diagnose this condition. 1,2 MHE is considered clinically relevant for at least 3 reasons. First, it impairs patients' daily functioning and

show abstract

“…23 The ''Sickness Impact Profile'' (SIP) questionnaire 24,25 is such an instrument for overall health assessment and has been used before to determine the influence of chronic liver disease on patients' daily functioning. [26][27][28][29] The aim of the present study was to determine the prevalence of neuropsychological and neurophysiological defects in stable cirrhotic patients attending a university hospital outpatient clinic using two neuropsychological tests and the neurophysiological method of automated analysis of the electroencephalogram (EEG). The SIP questionnaire was used to determine the influence of SHE on daily functioning.…”

mentioning

confidence: 99%

Subclinical hepatic encephalopathy impairs daily functioning

Groeneweg¹,

Quero²,

Bruijn³

et al. 1998

Hepatology

466

310

View full text Add to dashboard Cite

Subclinical hepatic encephalopathy (SHE) is assumed to have a negative effect on patients' daily functioning; therefore, treatment is recommended. However, no studies have been performed that document the clinical relevance of SHE. We performed a study in which the prevalence of SHE was determined in 179 outpatients with cirrhosis using two psychometric tests (Number Connection Test Part A [NCT-A] and the Digit Symbol Test [DGT]) and automated analysis of the electroencephalogram (EEG). SHE was defined by the presence of at least one abnormal psychometric test and/or abnormal slowing of the EEG. The influence of cirrhosis and SHE on patients' daily functioning was assessed using the Sickness Impact Profile (SIP) questionnaire. The distribution of SIP scores of the patients with cirrhosis differed from the reference scores of the general population. Patients with cirrhosis and SHE (n ‫؍‬ 48) reported significantly more impairment in all 12 scales of the SIP, in the psychosocial subscore, the physical subscore, as well as in the total SIP score, compared with cirrhotic patients without SHE (n ‫؍‬ 131). Multivariate analysis taking into account severity of liver disease (Child-Pugh score), presence of varices, and alcoholic etiology, showed that SHE independently was related to a diminished total SIP score. The reproducibility of the SIP was high when the test was repeated after a 3-month period. We conclude that SHE implies impaired daily functioning and warrants attempts at treatment. (HEPATOLOGY 1998;28:45-49.)Clinical manifestations of hepatic encephalopathy include a decreased intellectual function, personality disorders, an altered level of consciousness, and neuromuscular dysfunction. 1 In addition to clinical manifest hepatic encephalopathy, 2 a subclinical stage has been described, which cannot be detected through global clinical examination, but requires specific neuropsychological and neurophysiological examination. [3][4][5][6][7][8][9][10][11][12] The prevalence of subclinical hepatic encephalopathy (SHE) is estimated to vary from 30% to 84% according to recent studies using appropriate methods. [12][13][14][15][16] This variation in reported prevalence depends on the kind (psychometric or electrophysiological) and number of tests used, and the population (etiology and severity of the liver disease) tested. 17

show abstract

Severity of hepatic encephalopathy before liver transplantation is associated with quality of life after transplantation

Cited by 26 publications

References 0 publications

Health-related quality of life after liver transplantation

Health-related quality of life after liver transplantation

Lactulose improves cognitive functions and health-related quality of life in patients with cirrhosis who have minimal hepatic encephalopathy

Subclinical hepatic encephalopathy impairs daily functioning

Contact Info

Product

Resources

About