Usefulness of the Stroop Test in Diagnosing Minimal Hepatic Encephalopathy and Predicting Overt Hepatic Encephalopathy
Minimal hepatic encephalopathy (MHE) adversely affects the clinical outcomes of patients with liver cirrhosis. This prospective study aimed to evaluate the utility of the Stroop test in the diagnosis of MHE and prediction of overt hepatic encephalopathy (OHE) in Japanese patients with cirrhosis. We...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health/LWW
2021-09-01
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| Series: | Hepatology Communications |
| Online Access: | https://doi.org/10.1002/hep4.1738 |
| _version_ | 1811173690672414720 |
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| author | Tatsunori Hanai Makoto Shiraki Kayoko Nishimura Takao Miwa Toshihide Maeda Yui Ogiso Kenji Imai Atsushi Suetsugu Koji Takai Masahito Shimizu |
| author_facet | Tatsunori Hanai Makoto Shiraki Kayoko Nishimura Takao Miwa Toshihide Maeda Yui Ogiso Kenji Imai Atsushi Suetsugu Koji Takai Masahito Shimizu |
| author_sort | Tatsunori Hanai |
| collection | DOAJ |
| description | Minimal hepatic encephalopathy (MHE) adversely affects the clinical outcomes of patients with liver cirrhosis. This prospective study aimed to evaluate the utility of the Stroop test in the diagnosis of MHE and prediction of overt hepatic encephalopathy (OHE) in Japanese patients with cirrhosis. We enrolled 152 patients who underwent the Stroop test between November 2018 and February 2020. MHE was diagnosed using a combination of neuropsychological tests as the gold standard. The enrolled patients were followed up prospectively until the occurrence of OHE or August 2020. The optimal cutoff value of the Stroop test measurements was determined by receiver operating characteristic (ROC) curve analysis, and its predictive ability was assessed using the area under the ROC curve (AUC). Among the 139 eligible patients, 50 (36%) were diagnosed with MHE. The OffTime+OnTime cutoff value of 218.3 seconds had the best discriminative ability for MHE diagnosis, with an AUC of 0.77, a sensitivity of 74%, and a specificity of 75%. During a median follow‐up of 10.8 months, 6 (4%) patients developed OHE. The OffTime+OnTime cutoff value of 305.6 seconds had the highest predictive ability for OHE, with an AUC of 0.79, a sensitivity of 67%, and a specificity of 92%. This value predicted OHE occurrence independent of liver functional reserve and prior OHE (hazard ratio, 19.8; P = 0.003). These two cutoff values remained statistically significant even when patients with prior OHE were excluded from the analysis. Conclusion: The Stroop test was useful for diagnosing patients with MHE and predicting OHE in Japanese patients with cirrhosis. |
| first_indexed | 2024-04-10T17:52:20Z |
| format | Article |
| id | doaj.art-d59b53a0f21a494288f6f05a1b292b2f |
| institution | Directory Open Access Journal |
| issn | 2471-254X |
| language | English |
| last_indexed | 2024-04-10T17:52:20Z |
| publishDate | 2021-09-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Hepatology Communications |
| spelling | doaj.art-d59b53a0f21a494288f6f05a1b292b2f2023-02-02T20:59:54ZengWolters Kluwer Health/LWWHepatology Communications2471-254X2021-09-01591518152610.1002/hep4.1738Usefulness of the Stroop Test in Diagnosing Minimal Hepatic Encephalopathy and Predicting Overt Hepatic EncephalopathyTatsunori Hanai0Makoto Shiraki1Kayoko Nishimura2Takao Miwa3Toshihide Maeda4Yui Ogiso5Kenji Imai6Atsushi Suetsugu7Koji Takai8Masahito Shimizu9Department of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanCenter for Nutrition Support and Infection Control Gifu University Hospital Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanMinimal hepatic encephalopathy (MHE) adversely affects the clinical outcomes of patients with liver cirrhosis. This prospective study aimed to evaluate the utility of the Stroop test in the diagnosis of MHE and prediction of overt hepatic encephalopathy (OHE) in Japanese patients with cirrhosis. We enrolled 152 patients who underwent the Stroop test between November 2018 and February 2020. MHE was diagnosed using a combination of neuropsychological tests as the gold standard. The enrolled patients were followed up prospectively until the occurrence of OHE or August 2020. The optimal cutoff value of the Stroop test measurements was determined by receiver operating characteristic (ROC) curve analysis, and its predictive ability was assessed using the area under the ROC curve (AUC). Among the 139 eligible patients, 50 (36%) were diagnosed with MHE. The OffTime+OnTime cutoff value of 218.3 seconds had the best discriminative ability for MHE diagnosis, with an AUC of 0.77, a sensitivity of 74%, and a specificity of 75%. During a median follow‐up of 10.8 months, 6 (4%) patients developed OHE. The OffTime+OnTime cutoff value of 305.6 seconds had the highest predictive ability for OHE, with an AUC of 0.79, a sensitivity of 67%, and a specificity of 92%. This value predicted OHE occurrence independent of liver functional reserve and prior OHE (hazard ratio, 19.8; P = 0.003). These two cutoff values remained statistically significant even when patients with prior OHE were excluded from the analysis. Conclusion: The Stroop test was useful for diagnosing patients with MHE and predicting OHE in Japanese patients with cirrhosis.https://doi.org/10.1002/hep4.1738 |
| spellingShingle | Tatsunori Hanai Makoto Shiraki Kayoko Nishimura Takao Miwa Toshihide Maeda Yui Ogiso Kenji Imai Atsushi Suetsugu Koji Takai Masahito Shimizu Usefulness of the Stroop Test in Diagnosing Minimal Hepatic Encephalopathy and Predicting Overt Hepatic Encephalopathy Hepatology Communications |
| title | Usefulness of the Stroop Test in Diagnosing Minimal Hepatic Encephalopathy and Predicting Overt Hepatic Encephalopathy |
| title_full | Usefulness of the Stroop Test in Diagnosing Minimal Hepatic Encephalopathy and Predicting Overt Hepatic Encephalopathy |
| title_fullStr | Usefulness of the Stroop Test in Diagnosing Minimal Hepatic Encephalopathy and Predicting Overt Hepatic Encephalopathy |
| title_full_unstemmed | Usefulness of the Stroop Test in Diagnosing Minimal Hepatic Encephalopathy and Predicting Overt Hepatic Encephalopathy |
| title_short | Usefulness of the Stroop Test in Diagnosing Minimal Hepatic Encephalopathy and Predicting Overt Hepatic Encephalopathy |
| title_sort | usefulness of the stroop test in diagnosing minimal hepatic encephalopathy and predicting overt hepatic encephalopathy |
| url | https://doi.org/10.1002/hep4.1738 |
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