cliot (version 1.0.0)

hepatic_encephalopathy_grade: West Haven Criteria for Hepatic Encephalopathy Grades

Description

Calculates the West Haven grade for Hepatic Encephalopathy (HE). The grading is determined by the most severe symptom present across four categories: consciousness, intellectual function, behavior, and neuromuscular abnormalities.

Usage

hepatic_encephalopathy_grade(consciousness, intellect, behavior, neuromuscular)

Value

A list containing:

HE_Grade

The calculated West Haven Grade (0-4).

Description

Clinical description of the assigned grade.

Arguments

consciousness

Numeric (0-4). Level of consciousness. 0: Normal. 1: Mild lack of awareness, sleep disturbance. 2: Lethargic, disoriented to time. 3: Somnolent, semi-stupor. 4: Coma.

intellect

Numeric (0-4). Intellectual function. 0: Normal. 1: Shortened attention span, impaired addition/subtraction. 2: Disoriented to time, obvious personality change. 3: Gross disorientation. 4: Unable to test (Coma).

behavior

Numeric (0-4). Personality and behavior. 0: Normal. 1: Euphoria or anxiety. 2: Inappropriate behavior. 3: Bizarre behavior. 4: None (Coma).

neuromuscular

Numeric (0-4). Neuromuscular abnormalities. 0: None. 1: Tremor, apraxia, incoordination. 2: Asterixis (flapping tremor). 3: Asterixis usually present, hyperreflexia. 4: Decerebrate posturing.

References

Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014;60(2):715-735. doi:10.1002/hep.27210

Examples

# Example 1: Grade 2 (Lethargy and Asterixis present)
# Consciousness(2), Intellect(1), Behavior(1), Neuro(2)
hepatic_encephalopathy_grade(2, 1, 1, 2)

# Example 2: Grade 0 (Normal)
hepatic_encephalopathy_grade(0, 0, 0, 0)