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Development and validation of the AMMON-OHE model to predict risk of overt hepatic encephalopathy occurrence in outpatients with cirrhosis by Maria Pilar Ballester; Thomas H. Tranah; Lorenz Balcar; Alessandra Fiorillo; Javier Ampuero; Annarein J.C. Kerbert; Karen L. Thomsen; María Desamparados Escudero; Mattias Mandorfer; Thomas Reiberger; Debbie L. Shawcross; Manuel Romero-Gómez; Carmina Montoliu; Juan Antonio Carbonell-Asins; Rajiv Jalan is a Medicine article available to read on EtoBox.

What is Development and validation of the AMMON-OHE model to predict risk of overt hepatic encephalopathy occurrence in outpatients with cirrhosis about?

Background and aims Neuropsychological and psychophysical tests are recommended for the risk assessment for overt hepatic encephalopathy (OHE), but their accuracy is limited. Hyperammonaemia is central in the pathogenesis of OHE, but its predictive utility is unknown. This study aimed to determine the role of neuropsychological or psychophysical tests and ammonia and to develop the AMMON-OHE model for risk stratification regarding subsequent OHE development in outpatients with cirrhosis. Methods This observational, prospective study included 426 outpatients without previous OHE from 3 liver units followed for a median of 2.5 years. Psychometric hepatic encephalopathy score (PHES) <-4 or critical flicker frequency (CFF) <39 was considered abnormal. Ammonia was normalized to upper limit of normal (AMM-ULN) at the respective reference laboratory. Multivariable frailty competing risk analyses and random survival forest were performed to predict future OHE and to develop the AMMON-OHE model. External validation was carried out using 267 and 381 patients from two independent units. Results Significant differences were found in time-to-OHE (log-rank p<0.001) according to PHES or CFF and a

Who reads Development and validation of the AMMON-OHE model to predict risk of overt hepatic encephalopathy occurrence in outpatients with cirrhosis?

Author

Maria Pilar Ballester; Thomas H. Tranah; Lorenz Balcar; Alessandra Fiorillo; Javier Ampuero; Annarein J.C. Kerbert; Karen L. Thomsen; María Desamparados Escudero; Mattias Mandorfer; Thomas Reiberger; Debbie L. Shawcross; Manuel Romero-Gómez; Carmina Montoliu; Juan Antonio Carbonell-Asins; Rajiv Jalan

Publisher

Elsevier BV

Published

2023

Language

EN

Field

Medicine (Health Sciences)