hepatic_encephalopathy_grade: West Haven Criteria for Hepatic Encephalopathy Grades

In cliot: Clinical Indices and Outcomes Tools

West Haven Criteria for Hepatic Encephalopathy Grades

Description

Calculates the West Haven grade for Hepatic Encephalopathy (HE). The grading is determined by the most severe symptom present across four categories: consciousness, intellectual function, behavior, and neuromuscular abnormalities.

Usage

hepatic_encephalopathy_grade(consciousness, intellect, behavior, neuromuscular)

Arguments

consciousness	Numeric (0-4). Level of consciousness. 0: Normal. 1: Mild lack of awareness, sleep disturbance. 2: Lethargic, disoriented to time. 3: Somnolent, semi-stupor. 4: Coma.
intellect	Numeric (0-4). Intellectual function. 0: Normal. 1: Shortened attention span, impaired addition/subtraction. 2: Disoriented to time, obvious personality change. 3: Gross disorientation. 4: Unable to test (Coma).
behavior	Numeric (0-4). Personality and behavior. 0: Normal. 1: Euphoria or anxiety. 2: Inappropriate behavior. 3: Bizarre behavior. 4: None (Coma).
neuromuscular	Numeric (0-4). Neuromuscular abnormalities. 0: None. 1: Tremor, apraxia, incoordination. 2: Asterixis (flapping tremor). 3: Asterixis usually present, hyperreflexia. 4: Decerebrate posturing.

Value

A list containing:

HE_Grade	The calculated West Haven Grade (0-4).
Description	Clinical description of the assigned grade.

References

Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014;60(2):715-735. doi:10.1002/hep.27210

Examples

# Example 1: Grade 2 (Lethargy and Asterixis present)
# Consciousness(2), Intellect(1), Behavior(1), Neuro(2)
hepatic_encephalopathy_grade(2, 1, 1, 2)

# Example 2: Grade 0 (Normal)
hepatic_encephalopathy_grade(0, 0, 0, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.