Based on univariate analysis after comparing patients with MHE versus non-MHE, significant differences or tendencies were observed in 12 variables: age; Child–Pugh score; etiology; platelets; leukocytes; hematocrits; albumin; difference in coagulation time; presence of ascites; serum creatinine; and appetite measured by VeAS. In the first model, all the aforementioned variables were included except the Child–Pugh score (Table 4). MHE was the only variable that explained the differences observed in the domain of activity and was a factor associated with the variations observed in the domain of emotional selleck chemicals function, as well as in the overall score. The results obtained in the

second model learn more were similar to the first model, except in the domain of systemic symptoms, where MHE was a significant factor

(Table 5). The results of this study confirm that MHE is frequent and has a negative impact on the HRQL and on appetite in patients with decompensated cirrhosis, even though the cognitive abnormalities characteristic of MHE are not detected during routine medical examination. The prevalence of MHE in patients with cirrhosis has been estimated to be between 30% and 84%[5, 6] depending on the criteria used to make the diagnosis and the population being studied. According to the results of the present study, the prevalence of MHE in patients with decompensated cirrhosis was 44.0%, a value lower than that found by Maric et al., who reported a frequency of 80% in Liothyronine Sodium the same type of patients[30] The causes of these difference may be due to the fact that Maric et al. included

four patients with a history of OHE and only patients with Child B and C, while, based on the results of the present study, the prevalence of MHE was greater as the degree of hepatic damage increased (Child A 28.6% vs Child B 58.8% vs Child C 50%), results also observed in the study by Groeneweg et al.[31] and Román et al.[32] Likewise, the diagnosis of MHE was made only using two of the neuropsychological tests of reference – the numeric connection test A and the symbols and numbers test – without making an adjustment according to age or education level of patients, also including the encephalogram which showed low correlation with neuropsychological tests (Cohen’s κ = 0.32).[33] The encephalogram may be a diagnostic tool for patients with liver disease because it is associated with the severity of liver disease (Child–Pugh score) as well as the presence of OHE.[34] Nevertheless, currently its use as a diagnostic method for MHE is not very feasible due to its high cost and the need for specialized personnel for interpretation.[35-39] Compensated and decompensated cirrhosis are two entities that present distinct causes of death, survival and prognosis.[18, 40, 41] To date, the present study and that performed by Maric et al.