Introduction to the hepatic encephalopathy scoring algorithm (HESA)

Tarek I. Hassanein, Robin C. Hilsabeck, William Perry

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)529-538
Number of pages10
JournalDigestive Diseases and Sciences
Issue number2
StatePublished - Feb 2008


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

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology


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