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Cirrhosis Complication Linked to Increased Crash Risk

Patients with minimal hepatic encephalopathy have higher accident rates than those without

MONDAY, Sept. 28 (HealthDay News) -- In patients with cirrhosis, those with minimal hepatic encephalopathy diagnosed by the inhibitory control test have significantly higher motor vehicle crash rates than those without the condition, according to a study in the October issue of Hepatology.

Jasmohan S. Bajaj, M.D., of the Virginia Commonwealth University and McGuire VA Medical Center in Richmond, and colleagues used Department of Transportation (DOT) reports and self-reports to assess past one-year crash rates and one-year crash rates for a year of follow-up in 167 patients, including 97 with minimal hepatic encephalopathy diagnosed by the inhibitory control test, and 91 with minimal hepatic encephalopathy diagnosed by standard psychometric tests.

Compared to patients without minimal hepatic encephalopathy, the researchers found that those diagnosed by the inhibitory control test had significantly higher rates of past DOT-reported crashes (17 versus 3 percent) and past-year self-reported crashes (17 versus 0 percent). A significantly higher proportion of patients with crashes were diagnosed by the inhibitory control test than standard psychometric tests; and, those with minimal hepatic encephalopathy diagnosed by the inhibitory control test had significantly higher future DOT-reported crashes and violations than those without the condition (22 versus 7 percent).

"A careful elicitation of driving history and discussion with the patients and their families should be performed during clinic visits," the authors write. "Those patients with a higher prior motor vehicle crash and violation rate and with minimal hepatic encephalopathy may benefit from official DOT assessment."

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