The ability to drive a car may be impaired in patients with cirrhosis and minimal hepatic encephalopathy (MHE).
In this study, doctors from Germany evaluated patients with cirrhosis for MHE and the ability to drive a car.
|Significant differences were found in car handling, adaptation, and cautiousness.|
The team diagnosed MHE using 3 psychometric tests.
In addition, a blinded driving instructor assessed the patients' driving performance. The driving instructor rated patients on 4 global driving categories, 17 specific driving actions, and a total score of driving performance using a 6-point scale.
The team evaluated 274 consecutive patients with liver cirrhosis. Of these, 48 fulfilled the medical and driving inclusion criteria, 14 of them with and 34 without MHE.
In addition, 49 subjects in a stable phase of chronic gastroenterological diseases and with normal liver findings served as controls.
The doctors found that the total driving score of patients with MHE was significantly reduced compared with the cirrhotic patients without MHE or the controls.
Significant differences were found in car handling, adaptation, and cautiousness.
Differences were also found in specific driving actions.
Furthermore, the instructor had to intervene in the driving of 5 of the 14 MHE patients to avoid an accident. This was significantly more than in cirrhotic patients without MHE and in controls.
Dr Christian Wein and colleagues concluded, "Fitness to drive a car can be impaired in patients with MHE".
"Therefore, patients with liver cirrhosis should be tested for MHE and informed in the case of abnormal test results".
"Therapy known to improve psychometric test results should be initiated".