PHES scores have limited impact on the risk of overt HE in patients with minimal HE.

BACKGROUND:Minimal hepatic encephalopathy, defined by the portosystemic hepatic encephalopathy score (PHES), is associated with a higher risk of subsequent OHE. It remains unclear if there is a stepwise increase in OHE risk with worse PHES results. METHODS:In this multicenter study, patients with minimal hepatic encephalopathy, as defined by abnormal PHES, were followed for OHE development. RESULTS:In all, 207 patients were included. There was no stepwise increase in OHE risk with worse PHES results. CONCLUSIONS:Abnormal PHES is associated with a higher OHE risk, but we found no stepwise increase in OHE risk with worse PHES results below the established cutoff.