P1157 - Impact of Liver Frailty on Covert Hepatic Encephalopathy in Cirrhotic Patients: Insights From Guatemala on Liver Disease

Katherine E. Maldonado Cardona, MD, MSc¹, Kevin Alexander Molina Recinos, MD, MSc², Sergio Andres Cardona Chajón, MS³, Abel Alberto Sanchez Orozco, MD, MSc⁴, Bernardo Donery Lopez Samayoa, MD^5
1Gastroenterology & Digestive Endoscopy Unit of the Roosevelt Hospital at the University of San Carlos de Guatemala, Guatemala, Suchitepequez, Guatemala; ²Gastroenterology & Digestive Endoscopy Unit of the Roosevelt Hospital at the University of San Carlos de Guatemala, Guatemala, El Progreso, Guatemala; ³Centro Universitario Metropolitano School of Medicine at the University of San Carlos de Guatemala, Guatemala, Chimaltenango, Guatemala; ⁴Gastroenterology & Digestive Endoscopy Unit of the Roosevelt Hospital at the University of San Carlos de Guatemala, Guatemala City, San Marcos, Guatemala; ⁵Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

Introduction: Liver frailty has emerged as a key prognostic factor in cirrhosis, closely linked to sarcopenia, which exacerbates the pathophysiology of Hepatic Encephalopathy (HE), including its Covert form (CHE). The aim is to describe the probability of CHE based on the degree of frailty in cirrhotic patients, seeking to highlight the importance of routine frailty and CHE assessment in improving patient outcomes.

Methods: A cross-sectional analytical study was conducted at the Gastroenterology Unit at a Public Health Hospital from April 2021 to March 2022. The study included 66 patients who attended the outpatient clinic, excluding those with overt hepatic encephalopathy or unrelated neurocognitive impairments. Frailty was assessed using the Liver Frailty Index (LFI), CHE was evaluated using the Animal Naming Test (ANT), with a score below 15 indicating CHE. Demographic data, and clinical information were collected. Statistical analyses were performed using Jamovi 3.2 and Epidat 3.1 software, utilizing tests like Fisher’s exact test, Chi-square, and analysis of variance to compare groups and assess associations.

Results: The study included 66 patients, frailty distribution was 7.6% robust, 60.6% pre-frail, and 31.8% frail. CHE was present in 56.1% of patients, increasing with frailty: 20% in robust, 55% in pre-frail, and 66.7% in frail patients (p=0.087). The odds ratios for CHE were 2.75 (90% CI [0.61-12.2]) for pre-frail and 3.33 (90% CI [0.74-14.83]) for frail patients. Significant associations were found between lower education levels and CHE (p< 0.001), with mean years of education being 4 years in the CHE group versus 7 years in the non-CHE group. Age and education were significantly associated with frailty (p< 0.001 and p=0.025, respectively), with older age and lower education correlating with higher frailty levels.

Discussion: The study underscores the significant association between frailty and CHE in Guatemalan patients, highlighting the need for routine frailty assessments. The correlation between lower educational levels and CHE suggests that socioeconomic factors are critical in managing liver disease complications. Implementing simple diagnostic tools like LFI and ANT in clinical practice can enhance early identification and management of at-risk patients. Future research should focus on larger cohorts to validate these findings and explore additional influencing factors, aiming to improve clinical outcomes and quality of life for patients with cirrhotic in resource-limited settings.


Disclosures:


Katherine E. Maldonado Cardona, MD, MSc¹, Kevin Alexander Molina Recinos, MD, MSc², Sergio Andres Cardona Chajón, MS³, Abel Alberto Sanchez Orozco, MD, MSc⁴, Bernardo Donery Lopez Samayoa, MD⁵. P1157 - Impact of Liver Frailty on Covert Hepatic Encephalopathy in Cirrhotic Patients: Insights From Guatemala on Liver Disease, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.