Another study on HE: Accidents & Traffic Violations

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Minimal Hepatic Encephalopathy: A Vehicle for Accidents and Traffic

Violations

Authors: Bajaj, Jasmohan S.1; Hafeezullah, Muhammad1; Hoffmann,

G.2; Saeian, Kia1

Source: The American Journal of Gastroenterology, Volume 102, Number

9, September 2007

Abstract:

OBJECTIVES: & #8195;MHE patients have impairment on driving tests.

However, it is unclear whether this impairment is restricted to the

testing environment or is associated with increased traffic violations

and/or motor vehicle accidents.

METHODS: & #8195;An anonymous driving history and driving behavior

questionnaire (DBQ: self-scored, best score 104), coded according to

MHE status, was sent to 200 cirrhotics without overt hepatic

encephalopathy and 100 age/education-matched controls. The

questionnaire inquired about demographics, alcohol/illegal drug use,

and violations/accidents within 1 and 5 yr. The cirrhotics had been

divided into those with MHE (MHE+), without MHE (MHE & #8722;), and

those not tested for MHE because of psychoactive drug use, on a

previous study.

RESULTS: & #8195;Cirrhotics versus controls had similar driving

duration, alcohol/illegal drug use but significantly higher percentage

with violations within both 1 and 5 yr (25%vs 4%[5 yr]), 13%vs 2%[(1

yr]), accidents (17%vs 4%[5 yr]), 9%vs 1%[1 yr]), and both (34%vs 7%[5

yr], 18%vs 3%[1 yr]). MHE+ cirrhotics had significantly higher

percentage with violations (36%[5 yr], 21%[1 yr]), accidents (33%[5

yr]), 17%[1 yr]), and both (53%[5 yr], 33%[1 yr]) versus other

cirrhotics. DBQ score was significantly lower in cirrhotics than

controls (92 vs 99). Within cirrhotics, DBQ score was highest in

MHE-versus other groups. MHE+ status was the only risk factor (odds

ratios: 4.2-7.6) for violations and for accidents on multivariate

logistic regression.

CONCLUSIONS: & #8195;Cirrhotics have a higher self-reported occurrence

of violations and accidents compared to controls. MHE+ a is strong

predictor for violations and accidents. Prospective studies

investigating the effect of MHE treatment on violations and accidents

are warranted.

(Am J Gastroenterol 2007;102:1903-1909)