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臨床心理學刊
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| 篇名 | Cognitive Ability Screening Instrument in Detecting Cirrhotic Patients With Minimal Hepatic Encephalopathy in Taiwan: A Feasibility Study |
|---|---|
| 卷期 | 6:1 |
| 作者 | Yeh, Pin-yang 、 Lin, Wei-che 、 Cheng, Yu-fan 、 Wu, Ching-kuan |
| 頁次 | 032-032 |
| 關鍵字 | liver cirrhosis 、 minimal hepatic encephalopathy 、 CASI C-2.0 |
| 出刊日期 | 201206 |
中文摘要
英文摘要
Objective: Patients with severe cirrhosis often have minimal or overt hepatic encephalopathy (HE), which show cognitive disturbances. This study aimed to explore the ability of Cognitive Ability Screening Instrument (CASI) and Mini-Mental State Examination (MMSE) to detect the cognitive impairment in cirrhotic patients with HE.
Method: Twenty-seven cirrhotic patients were studied: 14 cirrhosis with minimal HE and 13 cirrhosis without minimal HE. All cirrhotic patients were investigated by the West Haven criteria. Patients who met the West Haven criteria (West Haven ≧1) were excluded from this study. Those who were free of any sign of encephalopathy (West Haven = 0) were assessed by the neuropsychological tests, such as digit span test, digit symbol test, block design test and Wisconsin Card Sorting Test (WCST) . Twenty-four healthy volunteers were recruited as a control group. The Chinese version of CASI (CASI C-2.0) and MMSE were applied. The cirrhotic patients in this study were transferred from the clinics. Before entering neuropsychological tests, they needed to accept many blood tests and biochemical examinations for liver transplantation. The control group didn't arranged to accept any biochemical tests, but their brain activities were confirmed by fMRI. The differences in demographic variables were determined by one-way analysis of variance (ANOVA). The method for analyzing the items of the CASI-C2.0 and MMSE were also determined by ANOVA. Scheffe's test was used for a posteriori comparison between groups; the level of statistical significance was set at p < .05. To assess the accuracy of CASI C-2.0 for discriminating in cirrhotic patient those with mHE from the control group, we plotted ROC curves and calculated the areas under the curves (AUC).
Results: The abstraction subset and total score of CASI C-2.0 were found a statistically significant difference between cirrhotic patients with the minimal HE and control group. The cutoff values of the abstraction subset and total score of CASI C-2.0 for detecting the cirrhotic patients with minimal HE were 9.5 and 95.25.
Conclusion: This study suggested that the abstraction subset and total score of CASI C-2.0 can be the indexes to detect the minimal HE at clinics.