Substance‐use simulation impairs driving capability in patients with cirrhosis regardless of hepatic encephalopathy

• DOI: 10.1002/hep4.2028
• Publication Date: 2022-07-17T17:23:35Z
• Authors: Chathur Acharya; Sara McGeorge; Andrew Fagan; James B. Wade; Hannah Lee; Velimir Luketic; Richard K. Sterling; Leroy Thacker; Jasmohan S. Bajaj
• Keywords: Hepatic Encephalopathy; Concomitant; Liver disease; Alcohol abuse

Abstract Driving is independently affected by cirrhosis and hepatic encephalopathy (HE) alcohol/substance use, but their concomitant impact unclear. We aimed to determine the of alcohol other substances on driving‐simulator performance in with without HE. Outpatients controls underwent cognitive testing driving simulation for following three conditions: baseline, wearing goggles simulating intoxication, opioid/benzodiazepine abuse. Outcomes were number centerline crossings (CCs) road‐edge excursions (REEs). compared versus patients then subjects HE all conditions, using generalized linear modeling (GLM). Sixty (17 controls, 43 [Model End‐Stage Liver Disease score, 10; 21 prior HE]) included. Simulations showed higher CCs REEs at baseline controls. With alcohol‐ substance abuse‐impairment goggles, increased decreased cirrhosis. In GLM, a time group interaction was seen ( p < 0.001) REEs. Patients than (CCs, = 0.003; REEs, 0.0001) 0.03) lower alcohol‐simulating goggles. All groups equally impaired opioid/benzodiazepine‐simulating 0.49; 0.46). Controls had similar as 0.98). conclusions : Simulating intake induces greater impairment patterns At have simulator outcomes equivalent intoxicated abuse could improve insight into errors enhance rehabilitation