Prevalence and risk factors of subclinical hepatic encephalopathy in patients with cirrhosis

Background: Subclinical hepatic encephalopathy (SHE) is considered an early stage of clinical encephalopathy and has been associated with shortened lifespan and increased healthcare-associated burden. We aimed to assess the prevalence of SHE in patients with cirrhosis and to elucidate the potential factors related to its occurrence. Methods: Thirty consecutive patients with cirrhosis were evaluated between March and July 2017. The exclusion criteria included overt hepatic encephalopathy, recent gastrointestinal hemorrhage, neurological disease, and the use of lactulose or non-absorbable antibiotics. After exclusion, 23 patients were included in this study. Twenty healthy age- and sex-matched controls were also included. SHE was assessed using the number connection test (NCT) and the inhibitory control test (ICT). Results: The NCT completion time was significantly longer in cirrhotic patients than in controls (77±45 vs. 27±6 sec, P