West Haven criteria
Gastroenterology and hepatology
Also known as: ISHEN classification · West-Haven-Kriterien (hepatische Enzephalopathie) · West Haven kriterleri (hepatik ensefalopati) · West Haven criteria for hepatic encephalopathy (with ISHEN covert/overt grouping)
What it is for
Clinical grading of hepatic encephalopathy (HE) in liver disease, with the International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) grouping into covert and overt HE.
Classification
| Category | Description |
|---|---|
| Minimal HE | no clinical signs; abnormalities only on psychometric or neurophysiological testing |
| Grade 1 | trivial lack of awareness, euphoria or anxiety, shortened attention span, impaired calculation, altered sleep rhythm |
| Grade 2 | lethargy or apathy, disorientation for time, obvious personality change, inappropriate behaviour, dyspraxia, asterixis |
| Grade 3 | somnolence to semi-stupor but responsive to stimuli, confusion, gross disorientation, bizarre behaviour |
| Grade 4 | coma |
| ISHEN grouping | covert HE = minimal HE plus grade 1; overt HE = grades 2–4 |
Source
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
AASLD / EASL · Hepatology 2014;60:715–735 (Vilstrup H et al.)
DOI: 10.1002/hep.27210
PMID: 25042402
- Edition
- West Haven criteria with the ISHEN covert/overt grouping, as in the AASLD/EASL 2014 practice guideline
- Checked on
Summary of the published classification in our own words. Not a substitute for the original publication.
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