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Model for Predicting Cirrhosis in Patient with Chronic Viral Hepatitis C (HCV)

Purpose: To predict the probability of cirrhosis in a patient with chronic viral hepatitis (HCV) using the model of Kaul et al.

Description

Kaul et al developed a model for predicting cirrhosis in a patient with chronic viral hepatitis C (HCV). This may help identify patients with cirrhosis without the need for liver biopsy. The authors are from Albert Einstein Medical Center and Thomas Jefferson University in Philadelphia.


 

Parameters:

(1) gender

(2) serum AST in IU/L

(3) presence or absence of spider nevi

(4) platelet count

 

Parameter

Finding

Points

gender

female

0

 

male

1

serum AST

<= 40 IU/L

0

 

> 40 IU/L

1

spider nevi

absent

0

 

present

1

platelet count

>= 140,000 per µL

0

 

< 140,000 per µL

1

 

X =

= (3.962053 * (points for gender)) + (4.260415 * (points for platelet count)) + (3.020743 * (points for AST)) + (3.0947 * (points for spider nevi)) - 7.962491

 

probability of cirrhosis =

= 1 / (1 + EXP((-1) * X))

 

Gender

Spider

AST

Platelet Count

Probability

Upper End 95% CI

female

absent

<= 40

>= 140

0.03%

0.04%

female

absent

> 40

>= 140

0.7%

3.1%

female

absent

<= 40

< 140

2.4%

10.6%

female

absent

> 40

< 140

34%

54%

female

present

<= 40

>= 140

0.8%

6.1%

female

present

> 40

>= 140

14%

45%

female

present

<= 40

< 140

35%

74%

female

present

> 40

< 140

92%

98%

male

absent

<= 40

>= 140

1.8%

7.2%

male

absent

> 40

>= 140

27%

40%

male

absent

<= 40

< 140

56%

84%

male

absent

> 40

< 140

96.4%

99%

male

present

<= 40

>= 140

29%

63%

male

present

> 40

>= 140

89%

97%

male

present

<= 40

< 140

96.6%

99%

male

present

> 40

< 140

99.8%

100%

 

Limitation:

• The method and reference range for the serum AST assay was not reported. An assumption is that 40 IU/L is the upper limit of the normal reference range for males and females.

 


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Specialty

Objective

ICD-10