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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    Hepatic Encephalopathy Grades/Stages

    West Haven Criteria. Defines criteria for the stages of hepatic encephalopathy.
    When to Use
    Why Use
    • Patients with known cirrhosis and prior hepatic encephalopathy.
    • Patients with or without known cirrhosis but suspected liver disease and altered mental status.

    The West Haven Criteria allow providers to classify severity of encephalopathy, communicate clearly about a patient's level of consciousness, and trend changes in their mental status.

    West Haven Criteria:
    Changes in behavior with minimal change in level of consciousness
    +1
    Gross disorientation, drowsiness, possibly asterixis, inappropriate behavior
    +2
    Marked confusion, incoherent speech, sleeping most of the time but arousable to vocal stimuli
    +3
    Comatose, unresponsive to pain; decorticate or decerebrate posturing
    +4

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Peter Ferenci

    About the Creator

    Peter Ferenci, MD, is a professor of medicine at the Medical University of Vienna, Austria. He practices within the department of internal medicine, gastroenterology and hepatology. He is Dr. honoris causae at the University of Cluj Napoca, Romania and the Semmelweis University, Budapest. Dr. Ferenci has published over 600 articles and abstracts on subjects including treatment of chronic viral hepatitis, inherited liver diseases and liver failure.

    To view Dr. Peter Ferenci's publications, visit PubMed

    Are you Dr. Peter Ferenci? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    About the Creator
    Dr. Peter Ferenci
    Are you Dr. Peter Ferenci?