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Thématique :
- Foie
Originalité :
Intermédiaire
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Dans certains cas
 
 
Nom du veilleur :
Professeur Christine SILVAIN
Coup de coeur :
 
 
Hepatology
  2017/07  
 
  2017 Jul;66(1):198-208.  
  doi: 10.1002/hep.29146  
 
  The animal naming test: An easy tool for the assessment of hepatic encephalopathy.  
 
  Campagna F, Montagnese S, Ridola L, Senzolo M, Schiff S, De Rui M, Pasquale C, Nardelli S, Pentassuglio I, Merkel C, Angeli P, Riggio O, Amodio P  
  https://www.ncbi.nlm.nih.gov/pubmed/28271528  
 
 

Abstract

Screening for hepatic encephalopathy (HE) that does not cause obvious disorientation or asterixis (minimal HE [MHE]/grade 1 HE) is important. We examined if the animal naming test (ANT1 ) (maximum number of animals listed in 1 minute) is useful in this context. In total, 208 healthy controls, 40 controls with inflammatory bowel disease, and 327 consecutive patients with cirrhosis underwent the ANT1 . Patients were tested for MHE by the psychometric HE score, and 146 were assessed by electroencephalography; 202 patients were followed up regarding the occurrence of overt HE and death. In the healthy controls, ANT1 was influenced by limited education (<8 years) and advanced age (>80 years, P < 0.001). Using an age and education adjusting procedure, the simplified ANT1 (S-ANT1 ) was obtained. An S-ANT1 of <10 animals was abnormal. Of the patients, 169 were considered unimpaired, 32 as having HE ≥grade 2, and 126 as having MHE/grade 1 HE. This group had lower S-ANT1 than unimpaired patients (12 ± 0.4 versus 16 ± 0.7, P < 0.001) and higher S-ANT1 than those with HE ≥grade 2 (4 ± 0.9). In grade 1 HE the S-ANT1 was lower than in MHE. Following receiver operating characteristic analysis (Youden's index), 15 animals produced the best discrimination between unimpaired and MHE/grade 1 HE patients. Thus, a three-level score (0 for S-ANT1 ≥15, 1 for 10 ≤ S-ANT1 < 15, 2 for S-ANT1 <10) was obtained. This score was correlated both to the psychometric HE score (P < 0.0001) and to electroencephalography (P = 0.007). By sample random split validation, both S-ANT1 and its three-level score showed prognostic value regarding the 1-year risk of overt HE and death. No inflammatory bowel disease control had S-ANT <15.

CONCLUSION:

The S-ANT1 is an easily obtainable measure useful for the assessment of HE. (Hepatology 2017;66:198-208).

 

 
Question posée
 
Validité du test ANT1 consistant à énumérer un nombre maximal de noms d’animaux en 1 minute pour l’évaluation de l’encéphalopathie hépatique minime ou de grade 1.
 
Question posée
 
Test facile avec limites faciles également à retenir: 10 et 15 en 1 minute avec adaptation facile en fonction du niveau d’éducation. Ce test a aussi une valeur pronostic : survenue d’épisodes d’encéphalopathie dans l’année et décès.
 
Commentaires

A valider dans une cohorte française car besoin de test simple pour l’évaluation de cette encéphalopathie minime.

 
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