Introduction Minimal hepatic encephalopathy (MHE) and physical frailty are highly prevalent yet often under-recognised complications in patients with advanced chronic liver disease (AdvCLD). While MHE reflects subtle neurocognitive impairment, frailty represents systemic physical vulnerability.
Introduction
Minimal hepatic encephalopathy (MHE) and physical frailty are highly prevalent yet often under-recognised complications in patients with advanced chronic liver disease (AdvCLD). While MHE reflects subtle neurocognitive impairment, frailty represents systemic physical vulnerability. Traditionally, complex tools like the Psychometric Hepatic Encephalopathy Score have limited routine clinical assessment of MHE. The simpler Stroop EncephalApp (StE) offers a practical alternative, raising interest in understanding how cognitive dysfunction—particularly psychomotor speed—relates to physical frailty.
Problem Statement
Despite both MHE and frailty being strong predictors of poor outcomes, their interrelationship remains poorly defined. Specifically, it is unclear whether cognitive impairment assessed by simple tools like StE correlates meaningfully with frailty indices and whether this relationship can be used for risk stratification in clinical practice.
Summary
In this multicenter study of patients awaiting liver transplantation, MHE was present in 73% and frailty in 18%. Patients with MHE had significantly worse Liver Frailty Index (LFI) scores and were more frequently classified as prefrail or frail. A strong correlation was observed between psychomotor speed—particularly StE off-time—and frailty, with LFI independently predicting MHE (OR 2.41).
These findings highlight a critical brain–muscle axis in cirrhosis, where impaired psychomotor speed mirrors physical decline. The study supports the use of simple bedside tools like StE to identify high-risk patients and suggests that integrated cognitive and physical interventions may improve outcomes in advanced liver disease.
Introduction: Acute kidney injury (AKI) is a frequent and life-threatening complication of cirrhosis, with management often complicated by inaccurate assessment of intravascular volume and the presence of cirrhotic cardiomyopathy (CCM). This prospective study evaluated whether...
Introduction: Acute-on-chronic liver failure (ACLF) is characterized by overwhelming systemic inflammation and immune dysregulation, leading to high short-term mortality. This study used advanced single-cell and spatial transcriptomic technologies to define the immune landscape of ACLF...
Introduction: Adults with Fontan-type circulation are increasingly recognized to develop Fontan-associated liver disease and portal hypertension. This prospective study explored the prevalence, anatomical distribution, and hemodynamic characteristics of esophageal varices (EV), with particular emphasis on...
Introduction: Acute-on-chronic liver failure (ACLF) is characterized by overwhelming systemic inflammation and immune dysregulation, leading to high short-term mortality. This study used advanced single-cell and spatial transcriptomic technologies to define the immune landscape of ACLF...
Introduction: Despite advances in the management of portal hypertension, mortality after variceal bleeding remains high in patients with cirrhosis. Experimental and clinical studies suggest that statins may improve portal hypertension and hepatic vascular function. This...
Introduction: Acute liver failure (ALF) complicated by cerebral oedema carries a high risk of early mortality, primarily due to hyperammonemia and intracranial hypertension. The optimal timing of continuous renal replacement therapy (CRRT) in these critically...
We are pioneers in clinical intelligence, dedicated to helping gastroenterologists harness the power of artificial intelligence to drive precision, efficiency, and patient growth.