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Introduction to the Hepatic Encephalopathy Scoring Algorithm (HESA)

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Abstract

A primary obstacle to early diagnosis and treatment of hepatic encephalopathy (HE) is the lack of a well-validated, standardized assessment method. The purpose of this study was to present preliminary validity data on a new method of grading HE, the Hepatic Encephalopathy Scoring Algorithm (HESA), which combines clinical impressions with neuropsychological performances to characterize HE. Participants were 49 inpatients admitted for complications of end stage liver disease. Each participant’s level of HE was graded using HESA and the West Haven Criteria (WHC) by independent raters blinded to each other’s rating. A moderately strong association was found between the two grading methods (r = 0.60), and individual HESA clinical and neuropsychological indicators were good discriminators among grades. The results also suggest HESA may be more sensitive to mental status impairment in the middle grades of HE than WHC. These findings suggest HESA holds promise as a multi-method approach to grading all levels of HE.

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Acknowledgements

The authors would like to express their deepest gratitude to Elizabeth Ziegler, Meghan Carlson, Fatma Barakat, and Scott Mooney for their invaluable help in assessing patients for this study, as well as to Deanna Oliver for organizing and facilitating study completion.

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Correspondence to Tarek I. Hassanein.

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Hassanein, T.I., Hilsabeck, R.C. & Perry, W. Introduction to the Hepatic Encephalopathy Scoring Algorithm (HESA). Dig Dis Sci 53, 529–538 (2008). https://doi.org/10.1007/s10620-007-9895-0

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  • DOI: https://doi.org/10.1007/s10620-007-9895-0

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