Correlation between the Degree of Liver Fibrosis and Driving Test Alterations as an Indicator of Minimal Hepatic Encephalopathy

Carlos Tornero^*, Simona Cioaia, Marina Llopis, Ana Ventura

Internal Medicine, Hospital Francesc de Borja, Gandia, Spain.

DOI: 10.4236/ojgas.2015.54006                

Abstract

Minimal hepatic encephalopathy is a subclinical disorder in patients with liver cirrhosis that may have an impact upon driving capacity. This study in highly selected patients without other confounding factors examines whether there is a relationship between the degree of liver fibrosis as determined by Fibroscan exploration and the driving test scores. Using the ASDE DRIVER-TEST N-845 system, validated for obtaining the driving license in Spain, we assessed the calculation of distances and time, bimanual visual-motor coordination, reaction time to different stimuli, concentrated attention, and resistance to monotony. The data were processed using the SPSS statistical package, with an analysis of the correlation between the degree of fibrosis and the test scores based on the Spearman statistic and the comparison of means (Mann-Whitney U-test). We found no alterations in driving capacity in patients diagnosed of hepatitis C with different degrees of early stage fibrosis or cirrhosis.

Keywords

Minimal Hepatic Encephalopathy, Driving

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Wang, J.-Y., Zhang, N.-P., Chi, B.-R., Mi, Y.-Q., Meng, L.-N., et al. (2013) Prevalence of Minimal Hepatic Encephalopathy and Quality of Life Evaluations in Hospitalizad Cirrhotic Patients in China. World Journal of Gastroenterology, 19, 4984-4991. http://dx.doi.org/10.3748/wjg.v19.i30.4984
[2]	Maldonado-Garza, H.J., Vázquez-Elizondo, G., Gaytán-Torres, J.O., Flores-Rendón, A.R., Cárdenas-Sandoval, M.G. and Bosques-Padilla, F.J. (2011) Prevalence of Minimal Hepatic Encephalopathy in Cirrhotic Patients. Annals of Hepatology, 10, S40-S44.
[3]	Bajaj, J.S. (2008) Management Options for Minimal Hepatic Encephalopathy. Expert Review of Gastroenterology and Hepatology, 2, 785-790. http://dx.doi.org/10.1586/17474124.2.6.785
[4]	Kharbanda, P.S., Saraswat, V.A. and Dhiman, R.K. (2003) Minimal Hepatic Encephalopathy: Diagnosis by Neuropsychological and Neurophysiologic Methods. Indian Journal of Gastroenterology, 22, S37-S41.
[5]	Dhiman, R.K. and Chawla, Y.K. (2009) Minimal Hepatic Encephalopathy. Indian Journal of Gastroenterology, 28, 5-16. http://dx.doi.org/10.1007/s12664-009-0003-6
[6]	Bajaj, J.S., Saeian, K., Schubert, C.M., Hafeezullah, M., Franco, J., et al. (2009) Minimal Hepatic Encephalopathy Is Associated with Motor Vehicle Crashes: The Reality beyond the Driving Test. Hepatology, 50, 1175-1183. http://dx.doi.org/10.1002/hep.23128
[7]	Wein, C., Koch, H., Popp, B., Oehler, G. and Schauder, P. (2004) Minimal Hepatic Encephalopathy Impairs Fitness to Drive. Hepatology, 39, 739-745. http://dx.doi.org/10.1002/hep.20095
[8]	Bajaj, J.S., Pinkerton, S.D., Sanyal, A.J. and Heuman, D.M. (2012) Diagnosis and Treatment of Minimal Hepatic Encephalopathy to Prevent Motor Vehicle Accidents: A Cost-Effectiveness Analysis. Hepatology, 55, 1164-1171. http://dx.doi.org/10.1002/hep.25507
[9]	Tornero, C., Ventura, A., Bourguet, M. and Poquet, I. (2012) Evaluation of Driving Ability among Residents after the Duty Shift. Accident Analysis & Prevention, 17, 182-183. http://dx.doi.org/10.1016/j.aap.2012.01.007
[10]	Tornero, C., Poquet, I., Bourguet, M., Gomis-Pajares, F., Ventura, A. and Mafe, M.C. (2012) Driving Skills in HIV Infected Patients Well Controlled with Antiretroviral Therapy. World Journal of AIDS, 2, 122-125. http://dx.doi.org/10.4236/wja.2012.23017
[11]	Poquet, I., Bourguet, M., Cioaia, S. and Tornero, C. (2014) Alteraciones de las habilidades para la conducción en pacientes que inician tratamiento con efavirez. Enfermedades Infecciosas y Microbiología Clínica, 32, 56-60. http://dx.doi.org/10.1016/j.eimc.2013.05.008
[12]	Monterde, H. (2005) Real Decreto 772/97 ASDE Driver-Test N-845. Examen psicológico de conductores en Espana con equipos normalizados.
[13]	Badenes Guia, D., Casas Hernanz, L., Aguilar Barberà, M. and Cejudo Bolivar, J.C. (2007) Discriminación de la valoración de la capacidad de conducción de vehículos en personas con diagnóstico de deterioro cognitivo ligero y demencia en los exámenes de conducción normalizados. Mafre Medicina, 18, 98-107.