Hepatic Encephalopathy: From the Pathogenesis to the New Treatments

Table 3

CHESS scale.

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Item	Score
	0	1
(1) Does the patient know which month he/she is in (i.e., January, February)?	Yes	No, he/she does not talk
(2) Does the patient know which day of the week he/she is in (i.e., Thursday, Friday, Sunday, etc.)?	Yes	No, he/she does not talk
(3) Can he/she count backward from 10 to 1 without making mistakes or stopping?	Yes	No, he/she does not talk
(4) If asked to do so, does he/she raise his/her arms?	Yes	No
(5) Does he/she understand what you are saying to him/her? (Based on the answers to questions 1 to 4)	Yes	No, he/she does not talk
(6) Is the patient awake and alert?	Yes	No, he/she is sleepy or fast asleep
(7) Is the patient fast asleep, and is it difficult to wake him/her up?	No	Yes
(8) Can he/she talk?	Yes	He/she does not talk
(9) Can he/she talk correctly? In other words, can you understand everything he/she says, and he/she does not stammer?	Yes	No, he/she does not talk or does not talk correctly
Total score of the CHESS:

The total score is the sum of the answers to the nine items. Minimal score = 0; maximal score = 9.
Source: Semin Liver Dis © 2008 Thieme Medical Publishers.