Managing Hepatic Encephalopathy

Among patients with cirrhosis, hepatic encephalopathy (HE) is the most common decompensating event (≈40%) and the most common cause of readmission (20%–50% at 90 days). In this clinical guideline, the first on this topic since the American Association for the Study of Liver Diseases’ 2014 guideline, authors present evidence that supports 24 recommendations and 29 “key concepts” (expert opinions).

Key Recommendations

Managing covert/minimal hepatic encephalopathy (C/MHE)

• Diagnosing C/MHE requires neuropsychological testing; don’t rely on serum ammonia to guide treatment decisions.

• Consider referral for C/MHE testing in patients with cirrhosis who have decompensation,…