Skip to content
Journal article

Introduction to the hepatic encephalopathy scoring algorithm (HESA)

Hassanein T, Hilsabeck R, Perry W...(+3 more)

Digestive Diseases and Sciences, vol. 53, issue 2 (2008) pp. 529-538

  • 14


    Mendeley users who have this article in their library.
  • 34


    Citations of this article.
  • N/A


    ScienceDirect users who have downloaded this article.
Sign in to save reference


A primary obstacle to early diagnosis and treatment of hepatic encephalopathy (HE) is the lack of a well-validated, standardized assessment method. The purpose of this study was to present preliminary validity data on a new method of grading HE, the Hepatic Encephalopathy Scoring Algorithm (HESA), which combines clinical impressions with neuropsychological performances to characterize HE. Participants were 49 inpatients admitted for complications of end stage liver disease. Each participant's level of HE was graded using HESA and the West Haven Criteria (WHC) by independent raters blinded to each other's rating. A moderately strong association was found between the two grading methods (r = 0.60), and individual HESA clinical and neuropsychological indicators were good discriminators among grades. The results also suggest HESA may be more sensitive to mental status impairment in the middle grades of HE than WHC. These findings suggest HESA holds promise as a multi-method approach to grading all levels of HE.

Author-supplied keywords

  • Chronic liver disease
  • Cognitive impairment
  • End stage liver disease
  • Hepatic encephalopathy
  • Hepatitis C
  • Neuropsychological assessment

Find this document

Get full text

Cite this document

Choose a citation style from the tabs below