BACKGROUND Chronic liver diseases are significant risk factors for morbidity and mortality.
1 On a global scale, chronic liver diseases affect an estimated 844 million individuals and
are responsible for 2 million deaths annually, 1 million of which are related to cirrhosis and
its complications. 1, 2 In the United States, the use and cost burden of cirrhosis and its
complications doubled between 2001 and 2011 3 and such burdens continued to increase
over recent years. 4 Hepatic encephalopathy is a major neuropsychiatric a Department of …

As the prevalence of chronic liver disease increases throughout the United States, the health
care burden of HE will continue to grow. HE results in direct health care costs through health
care utilization and hospital admissions. Furthermore, HE creates indirect costs for patients
and caregivers by affecting ability to work and quality of life. Current quality improvement
initiatives are focused on improving transitions of care for patients with HE and decreasing
hospital readmissions. There is also ongoing research focused on developing novel …