Русский
Diagnostical value of methods for cognitive impairments assessing in patients with liver cirrhosis
DOI: https://dx.doi.org/10.18565/therapy.2024.5.31-38
Galieva A.M., Mukhametova D.D., Belousova E.N., Khazieva G.R., Valitova A.D., Levanova P.I., Odintsova A.Kh., Abdulganieva D.I.
1) Kazan State Medical University of the Ministry of Healthcare of Russia; 2) Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan, Kazan
The aim: to estimate the diagnostic value of tests used to evaluate HE in LC patients.
Material and methods. 86 LC patients hospitalized in gastroenterology department of Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan, Kazan were involved in the study. The average age of patients was 52 [43; 62] years, rate of females was 65%. For determination the stage of HE West – Haven criteria were used. The average MELD score was 14 [9; 20]. Number connecting test (NCT), MoCA scale, MMSE scale and blood ammonium level assessment were used in 84, 26, 28 and 45 patients, respectively.
Results. According to West – Haven criteria, 78 (90%) participants had HE: minimal HE – 22 (26%), stage 1 HE – 42 (50%), stage 2 HE – 14 (14%) persons. In 73 (87%) patients, the time required to perform NCT exceeded the norm. The average NCT value was 68 [49; 110.5] sec. Sensitivity of NCT for HE detecting was 93.4%, specificity – 75%, positive predictive value (PPV) – 97.3%. In 14 patients (54%), MoCA test scores were below normal, the average score was 25 [20; 28]. MoCA had a sensitivity for detecting HE of 63.6%, specificity of 100%, and PPV of 100%. In 20 patients (71%), the result on the MMSE test was below normal, the average score was 26.5 [24; 29]. The sensitivity of MMSE was 79.2%, specificity – 75%, PPV – 95%. 41 patients (91%) had elevated levels of ammonium in the blood, and 4 had normal levels. The average value of this indicator was 97 [66; 177] µmol/l. Sensitivity of blood ammonium determination for identifying HE was 90.24%, PPV – 90.24%.
Conclusion. NCT had the highest sensitivity for HE detecting, but its specificity was comparable to MMSE. MoCA had the highest specificity but low sensitivity. High sensitivity for HE detecting was also fixed for ammonium level determination.
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About the Autors
Alsou M. Galieva, resident of the Department of hospital therapy, Kazan State Medical University of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 49 Butlerova St.
E-mail: also101@gmail.com
ORCID: https://orcid.org/0000-0002-8026-6698
Dilyara D. Mukhametova, MD, PhD (Medicine), assistant at the Department of hospital therapy, Kazan State Medical University of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 49 Butlerova St.
E-mail: muhdilyara@gmail.com
ORCID: https://orcid.org/0000-0003-2102-0142
Elena N. Belousova, MD, PhD (Medicine), assistant at the Department of hospital therapy, Kazan State Medical University of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 49 Butlerova St.
E-mail: vanilla16@mail.ru
ORCID: https://orcid.org/0000-0001-9369-4993
Gulshat R. Khazieva, resident of the Department of hospital therapy, Kazan State Medical University of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 49 Butlerova St.
E-mail: postgulshat@mail.ru
ORCID: https://orcid.org/0009-0007-1006-8649
Azalia D. Valitova, student of Kazan State Medical University of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 49 Butlerova St.
Email: azali1903@gmail.com
ORCID: https://orcid.org/0000-0001-8980-5830
Polina I. Levanova, MD, gastroenterologist at the Department of gastroenterology, Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan. Address: 420064, Kazan, 138 Orenburgsky Tract.
E-mail: levanpi97@gmail.com
ORCID: https://orcid.org/0009-0007-9257-9206
Alfiya Kh. Odintsova, MD, PhD (Medicine), head of the Department of gastroenterology, Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan. Address: 420064, Kazan, 138 Orenburgsky Tract.
E-mail: odincovaa@yandex.ru
ORCID: https://orcid.org/0000-0002-7148-8862
Diana I. Abdulganieva, MD, PhD (Medicine), head of the Department of hospital therapy, Kazan State Medical University of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 49 Butlerova St.
E-mail: diana_s@mail.ru
ORCID: https://orcid.org/0000-0001-7069-2725
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