Clinical Trials Study
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2014; 20(42): 15756-15762
Published online Nov 14, 2014. doi: 10.3748/wjg.v20.i42.15756
Covert hepatic encephalopathy: Agreement and predictive validity of different indices
Sara Montagnese, Esmeralda Balistreri, Sami Schiff, Michele De Rui, Paolo Angeli, Giacomo Zanus, Umberto Cillo, Giancarlo Bombonato, Massimo Bolognesi, David Sacerdoti, Angelo Gatta, Carlo Merkel, Piero Amodio
Sara Montagnese, Esmeralda Balistreri, Sami Schiff, Michele De Rui, Paolo Angeli, Giancarlo Bombonato, Massimo Bolognesi, David Sacerdoti, Angelo Gatta, Carlo Merkel, Piero Amodio, Department of Medicine, University of Padova, 35128 Padova, Italy
Giacomo Zanus, Umberto Cillo, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, 35128 Padova, Italy
Author contributions: Montagnese S contributed to the study concept and design; acquisition, analysis and interpretation of data; drafting of the manuscript; Balistreri E contributed to the acquisition, analysis and interpretation of data; drafting of the manuscript; Schiff S contributed to the acquisition, analysis and interpretation of data; technical and material support; De Rui M contributed to the acquisition, analysis and interpretation of data; drafting of the manuscript; Angeli P, Zanus G, Cillo U and Bombonato G contributed to the acquisition of data; patient recruitment, technical and material support; Bolognesi M and Sacerdoti D contributed to the acquisition of data; technical and material support; Gatta A contributed to the study supervision; technical and material support; Merkel C contributed to the study concept and design; analysis and interpretation of data; Amodio P contributed to the study concept and design; analysis and interpretation of data; study supervision.
Supported by (in Part) Grant from the Italian Ministry of Health to Sara Montagnese (Giovani Ricercatori 2009); and Grants from the University of Padova to Piero Amodio; Publication fees were covered by the Foundation Lionello Forin Hepatos Onlus, Padova, Italy.
Correspondence to: Sara Montagnese, MD, Department of Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy. sara.montagnese@unipd.it
Telephone: +39-49-8218675 Fax: +39-49-8754179
Received: March 22, 2014
Revised: May 16, 2014
Accepted: June 14, 2014
Published online: November 14, 2014
Processing time: 239 Days and 17.7 Hours
Core Tip

Core tip: Covert hepatic encephalopathy is a heterogeneous entity, which should probably be sought for by a combination of clinical, neurophysiological and neuropsychological indices. Grade I hepatic encephalopathy (HE), as diagnosed by an experienced clinician, holds prognostic relevance and is associated with a higher degree of hepatic failure. Thus, while its use as an outcome for clinical trials is not recommended, the abolition of Grade I HE seems premature.