■肝性脑病(HE)意味着高发病率和死亡率。隐蔽HE(CHE)的评估[即最小HE(MHE)加1级HE]在台湾经常被忽视。因此,目的是调查动物命名测试(ANT1和简化ANT1(S-ANT1))在华语地区评估CHE的潜力,特别是台湾。
■进行了一项前瞻性队列研究,包括65例肝硬化患者和29例健康对照(患者亲属)。每三个月对患者进行随访,并在两年后或直至死亡进行审查。考虑了明显HE(OHE)的住院和死亡率。所有受试者均接受ANT1,心理测量HE评分(PHES),和小型精神状态检查(MMSE)。患者接受了脑电图(EEG)以检测MHE的减慢指示。通过ROC分析和Youden指数评估ANT1和S-ANT1的截止值,考虑CHE作为参考。评估了OHE和无OHE生存的预后价值。
■初步分析证实,PHES≤-4是异常结果的良好判别点。在29例患者中发现了CHE:9例患有MHE(PHES≤-4或EEG改变),20例患有1级HE。发现ANT1和S-ANT1分别具有CHE的诊断值:AUC=0.807,0.786;截止值:18和19。发现ANT1和S-ANT1对OHE具有预后价值,OHE住院次数,和无OHE复发生存。
■ANT1有望成为CHE检测的工具,量化,以及在台湾和其他华语地区的后续行动。关键信息动物命名测试(ANT1)是一种简单有效的语义流畅性测试,可以在一分钟内在门诊或床边设置中轻松进行,也可以用作隐性肝性脑病(CHE)检测的工具,量化,以及在台湾的后续行动,其他华语地区,和许多其他国家。发现ANT1和S-ANT1对CHE的诊断价值显著,受试者工作特征曲线下面积(AUROC)值分别为0.807和0.786,截止分数为18分和19分。ANT1和S-ANT1对明显肝性脑病(OHE)的首次突破具有预后价值,OHE住院次数,和OHE无复发生存率,独立于MELD评分。
Hepatic encephalopathy (HE) implies high morbidity and mortality. The assessment of covert HE (CHE) [i.e. minimal HE (MHE) plus grade 1 HE] is often neglected in Taiwan. Therefore, the aim was to investigate the potential of the animal naming test (
ANT1 and simplified
ANT1 (S-ANT1)) for assessing CHE in Chinese-speaking regions, specifically Taiwan.
A prospective cohort study was conducted, comprising 65 cirrhotic patients and 29 healthy controls (relatives of the patients). Patients were followed up every three months and censored after two years or until death. Hospitalization for overt HE (OHE) and mortality were considered. All subjects underwent ANT1, psychometric HE score (PHES), and mini-mental state examination (MMSE). The patients underwent an electroencephalogram (EEG) to detect slowing indicative of MHE. Cut-off values for
ANT1 and S-
ANT1 were assessed by ROC analysis and Youden\'s index, considering CHE as a reference. The prognostic values for OHE and OHE-free survival were assessed.
Preliminary analysis confirmed that PHES ≤-4 is a good discriminant point for abnormal results. CHE was found in 29 patients: 9 had MHE (PHES ≤ -4 or altered EEG) and 20 had grade 1 HE.
ANT1 and S-
ANT1 were found to have diagnostic values for CHE: AUC = 0.807, 0.786; cut off: 18 and 19, respectively.
ANT1 and S-
ANT1 were found to have prognostic value for OHE, number of hospitalization episodes for OHE, and OHE recurrence-free survival.
ANT1 shows promise as a tool for CHE detection, quantification, and follow-up in Taiwan and other Chinese-speaking regions.Key messagesThe animal naming test (ANT1) is a simple and valid semantic fluency test that can be easily performed in outpatient or bedside settings in one minute and can also be used as a tool for covert hepatic encephalopathy (CHE) detection, quantification, and follow-up in Taiwan, other Chinese-speaking regions, and many other countries.The diagnostic value of ANT1 and S-ANT1 for CHE were found to be significant, with area under the receiver operating characteristic curve (AUROC) values of 0.807 and 0.786 respectively, and cut-off scores of 18 and 19.
ANT1 and S-
ANT1 have prognostic value for the first breakthrough of overt hepatic encephalopathy (OHE), number of hospitalization episodes for OHE, and OHE recurrence-free survival, independent of the MELD score.