Abstract:
Background: Covert hepatic encephalopathy (CHE) is underdiagnosed and is difficult to detect. The EncephalApp Stroop test is validated for its screening. The aim of the study was to define Tunisian norms for the test based on healthy controls norms and to estimate the prevalence of CHE in cirrhotic Tunisian patients. Methods: A prospective, multicenter, cross-sectional study was conducted. Ambulatory or hospitalized cirrhotic patients aged 40 years and over were recruited at 11 centers. Healthy subjects aged 40 years and over were recruited at 8 centers. We used a translated Arabic version of the streamlined EncephalApp Stroop test. The task has two components: \"Off\" and \"On\" state depending on the discordance or concordance of the stimuli. Results: 142 patients were included. The mean age was 57.26 years [40-86]. 40 (28.17%) of cirrhotic patients who were included were diagnosed as having a minimal hepatic encephalopathy or CHE. Among the ineligible patients, 22 had overt hepatic encephalopathy. If we consider these patients, the overall prevalence rate of CHE was around 24.39% in cirrhotic patients. It was more frequent in women (34.21% vs 25.96%), and in patients whose level of school education is between 6 and 13 years. Its prevalence does not appear to be affected by gender, MELD score, etiology of cirrhosis and age group of patients, as these variables were independent with respective p according to the chi-square test 0.413; 0.736; 0.663 and 0.1. The stroop times (On / Off and On + Off) correlated significantly with each other, are associated significantly and positively with age (respective Pearson coefficients: 0.578; 0.567 and 0.6). The more the age increases, the more the stroop response times increases (p > 10 -3). Conclusions: EncephalApp Stroop test was an efficient screening tool for CHE in Tunisian cirrhotic patients.
摘要:
背景:隐性肝性脑病(CHE)未被诊断且难以发现。EnbheadAppStroop测试已通过筛选验证。该研究的目的是根据健康对照标准定义突尼斯标准,并估计肝硬化突尼斯患者中CHE的患病率。方法:前瞻性,多中心,进行了横断面研究。在11个中心招募了40岁及以上的门诊或住院肝硬化患者。在8个中心招募了40岁及以上的健康受试者。我们使用了经过翻译的阿拉伯语版本的简化EncephalAppStroop测试。该任务有两个组成部分:“关”和“开”状态取决于刺激的不一致或一致。结果:共纳入142例患者。平均年龄为57.26岁[40-86]。40(28.17%)的肝硬化患者被诊断为具有轻微的肝性脑病或CHE。在不合格的患者中,22例有明显的肝性脑病。如果我们考虑这些病人,肝硬化患者CHE的总体患病率约为24.39%.在女性中更为常见(34.21%对25.96%),以及学校教育水平在6至13年之间的患者。其患病率似乎不受性别影响,MELD得分,肝硬化的病因和患者的年龄组,因为根据卡方检验,这些变量与各自的p无关0.413;0.736;0.663和0.1。stroop时间(开/关和开+关)彼此显著相关,与年龄显著正相关(相应的皮尔逊系数:0.578;0.567和0.6)。年龄越大,stroop响应时间增加越多(p>10-3)。结论:EnheadAppStroop试验是突尼斯肝硬化患者CHE的有效筛查工具。