Minimal hepatic encephalopathy is associated with falls

Minimal hepatic encephalopathy is associated with falls

Falls are more frequent in cirrhotic patients with minimal hepatic encephalopathy, particularly in those on treatment with psychoactive drugs, reports this month's issue of the American Journal of Gastroenterology.

Minimal hepatic encephalopathy reduces quality of life and impacts daily functioning.

It is known to impair fitness to drive, but deficits in attention and reaction may also be associated with falls.

Falls may have important consequences in patients with cirrhosis due to coagulopathy, osteoporosis, and operative risk.

However, the relationship between minimal hepatic encephalopathy and falls has not yet been evaluated.
The proportion with minimal hepatic encephalopathy reporting falls was 40%
American Journal Gastroenterology

Dr Germán Soriano and colleagues from Spain retrospectively investigated whether minimal hepatic encephalopathy is associated with falls in patients with cirrhosis.

The research team evaluated 130 cirrhotic outpatients and 43 controls.

Minimal hepatic encephalopathy was diagnosed according to the results of the psychometric hepatic encephalopathy score.

The research team recorded the reported incidence and number of falls in the 12 months before the study, the severity of injuries, and the need for healthcare services.

The researchers found that 35% of patients with cirrhosis exhibited minimal hepatic encephalopathy.

The proportion of patients with minimal hepatic encephalopathy that reported falls was 40%, higher than those without minimal hepatic encephalopathy, which was similar to controls.

In patients with minimal hepatic encephalopathy, there was a higher need for primary healthcare services and hospitalization due to falls than in patients without minimal hepatic encephalopathy.

The team observed that patients on psychoactive drugs showed a stronger association between minimal hepatic encephalopathy and falls.

The team reported that 75% of patients with minimal hepatic encephalopathy presented with falls vs 15% of patients without minimal hepatic encephalopathy.

In patients not receiving psychoactive drugs, the incidence of falls was 32% in patients with minimal hepatic encephalopathy vs 13% in those without minimal hepatic encephalopathy.

Multivariate analysis showed that minimal hepatic encephalopathy, previous encephalopathy, and antidepressant therapy were independent factors associated to previous falls.

Am J Gastroenterol 2011; 106:476–482
16 March 2011