INTRODUCTION Covert/minimal hepatic encephalopathy (C/MHE) is the mildest form of hepatic encephalopathy (HE), but it is closely related to the quality of life and prognosis of patients with cirrhosis. Currently, the epidemiological data of C/MHE have not been well described. METHODS We searched the PubMed, Embase, and Cochrane Library databases for relevant articles. We performed a random-effects meta-analysis of proportions to estimate the pooled prevalence of C/MHE in patients with cirrhosis. We also examined potential risk factors for C/MHE by comparing characteristics of patients with and without C/MHE. RESULTS Finally, a total of 101 studies were included. The prevalence of C/MHE was 40.9% (95% confidence interval, 38.3%-43.5%) among patients with cirrhosis worldwide. The pooled C/MHE prevalence was 39.9% (95% confidence interval 36.7%-43.1%) based on studies using the psychometric HE score as a diagnostic tool. Meta-regression models showed that geographic region, sample size, mean age, sex ratio, and Child-Pugh classification were influencing factors for the heterogeneity of C/MHE prevalence. The presence of C/MHE was found to be associated with various factors including age, level of education, alcoholic etiology, Child-Pugh classification, MELD score, history of overt HE, presence of other complications, and laboratory tests related to impaired liver function. DISCUSSION This study reports detailed data on the prevalence of C/MHE as well as clinical features associated with C/MHE, suggesting that C/MHE is one of the most common complications of liver cirrhosis.

中文翻译：

---

肝硬化患者隐性/轻微肝性脑病的患病率和特征：系统评价和荟萃分析。

引言 隐性/轻微肝性脑病（C/MHE）是肝性脑病（HE）中最温和的一种形式，但与肝硬化患者的生活质量和预后密切相关。目前，C/MHE的流行病学数据尚未得到很好的描述。方法 我们在 PubMed、Embase 和 Cochrane 图书馆数据库中检索了相关文章。我们对比例进行了随机效应荟萃分析，以估计肝硬化患者中 C/MHE 的汇总患病率。我们还通过比较患有和不患有 C/MHE 的患者的特征来检查 C/MHE 的潜在危险因素。结果最终总共纳入了 101 项研究。全球肝硬化患者中 C/MHE 的患病率为 40.9%（95% 置信区间，38.3%-43.5%）。根据使用心理测量 HE 评分作为诊断工具的研究，汇总的 C/MHE 患病率为 39.9%（95% 置信区间 36.7%-43.1%）。荟萃回归模型显示，地理区域、样本量、平均年龄、性别比和Child-Pugh分类是C/MHE患病率异质性的影响因素。研究发现 C/MHE 的存在与多种因素相关，包括年龄、教育水平、酒精病因、Child-Pugh 分类、MELD 评分、明显 HE 病史、其他并发症的存在以及与肝功能受损相关的实验室检查。讨论 本研究报告了 C/MHE 患病率以及与 C/MHE 相关的临床特征的详细数据，表明 C/MHE 是肝硬化最常见的并发症之一。