This is an unprecedented time. It is the dedication of healthcare workers that will lead us through this crisis. Thank you for everything you do.

      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm





    Chief Complaint


    Organ System


    Patent Pending

    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
    Gross disorientation, drowsiness, possibly asterixis, inappropriate behavior
    Marked confusion, incoherent speech, sleeping most of the time but arousable to vocal stimuli
    Comatose, unresponsive to pain; decorticate or decerebrate posturing


    Please fill out required fields.

    Next Steps
    Creator Insights


    • Lactulose is a standard treatment for hepatic encephalopathy
    • Ammonia testing may be helpful diagnostically or trending levels
    • There should always be consideration to other causes of altered mental status in these patients, as they are at high risk for comorbidities including bleeding, infection, drug interactions, and electrolyte disturbances.
    About the Creator
    Dr. Peter Ferenci
    Are you Dr. Peter Ferenci?