Abstract
Background
Diagnosis of covert hepatic encephalopathy (CHE) is time consuming in clinical practice.
Recently, a new diagnostic tool - the simplified Animal Naming Test (S-ANT1) - was
presented with promising results in an Italian cohort. The aim of the present study
was to validate S-ANT1 in a cohort of cirrhotic patients from a German tertiary referral
centre.
Methods
143 cirrhotic patients and 37 healthy controls were enrolled. Hepatic encephalopathy
(HE) grade 1 (HE1) was clinically diagnosed according to the West-Haven Criteria.
Critical flicker frequency and Psychometric Hepatic Encephalopathy Score were used
to detect minimal HE (MHE). All participants were additionally examined by S-ANT1.
Results
58 (40.6%) patients presented with CHE (40 MHE, 18 HE1). S-ANT1 was lowest in patients
with HE1, followed by patients with MHE, patients without CHE, and healthy controls,
respectively (each p < 0.05). Naming <20 animals discriminated best between patients
with and without CHE in ROC analysis (with Youden's index). With a cut-off value of
≥23 mentioned animal names further testing for CHE could be avoided in 38.5% of patients
with a negative predictive value of 84%.
Conclusions
S-ANT1 may become an important first screening tool for the assessment of CHE in clinical
practice.
Keywords
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Article info
Publication history
Published online: August 19, 2018
Accepted:
August 13,
2018
Received:
July 13,
2018
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
