Frequency of covert hepatic encephalopathy in chronic liverdisease patients

Submission: 20 October 2025 | Acceptance: 13 November | Publication: 27 November

Noor Hussain, Kamlesh Kumar Ahuja, Hakim Ali Abro, Sultan Ahmed Chandio, Vishumber Lal, Nisar Ahmed Seelro 

Shaheed Mohtarma Benazir Bhutto Medical University (SMBBMU), Larkana, Sindh 

ABSTRACT 

Objective: To determine the frequency of covert hepatic encephalopathy in patients with chronic liver disease, and to identify associated demographic, clinical, and etiological factors using standardized psychometric assessments.

Study Design: The research followed the framework ofdescriptive cross-sectional design.

The research was carried out within the parameters of the Department of General Medicine, Shaheed Mohtarma Benazir Bhutto Medical University (SMBBMU), Larkana, and was performed between July 2025 and October 2025.

Methodology: A total of 323 adult patients aged 18–80 years with chronic liver disease were enrolled using consecutive sampling, excluding those with overt hepatic encephalopathy or major neurological/psychiatric disorders. Covert hepatic encephalopathy was diagnosed using standardized psychometric tests. Demographic, clinical, and laboratory data were collected and analyzed in SPSS version 26 with descriptive and inferential statistics, considering p<0.05 significant.

Results: Covert hepatic encephalopathy (CHE) was present in 34.4% of patients. The overall mean age was 47.8 ± 12.0 years, with males comprising 65.0% of the study population. Patients with CHE were significantly older than those without CHE (54.34 ± 11.28 vs. 44.37 ± 10.95 years; p = 0.0001). No significant associations were observed with disease duration (p = 0.838), gender (p = 0.653), or mortality (p = 0.858).

Conclusion: The phenomenon of covert hepatic encephalopathy was observed in one-third of individuals afflicted with chronic liver disease, with advancing age identified as the sole statistically significant predictor. There were no statistically significant associations between either gender, the duration of the disease, or even mortality. These findings underscore the urgent need to conduct neuropsychological assessments on a regular basis, especially in the elderly population with chronic liver disease, to facilitate early detection, early intervention and avoidance of the development of overt hepatic encephalopathy. 

Keywords: Chronic Liver Disease, Hepatic Encephalopathy, Covert Hepatic Encephalopathy,

Cirrhosis,