Bhatia et al developed a prognostic model for a patient presenting with acute liver failure. The authors are from All India Institute of Medical Science in New Delhi.
Patient: acute liver failure
An elevated arterial ammonia correlates with:
(1) more complications
(2) more severe encephalopathy
(3) cerebral edema
(4) respiratory failure requiring mechanical ventilation
(5) seizures
(6) higher mortality rate
Parameters:
(1) arterial ammonia in µmol/L (Randox Lab Ltd, UK; reference range 10 to 47 µmol/L)
(2) cerebral edema
(3) arterial pH
Parameter
Finding
Points
arterial ammonia
< 124 µmol/L
0
>= 124 µmol/L
2.91
cerebral edema
absent
present
2.41
arterial pH
> 7.40
<= 7.40
1.40
where:
• 124 µmol is 2.6 times the upper limit of the normal reference range.
Z =
= SUM(points for the 3 parameters) - 2.53
probability of mortality =
= (1 / (1 + EXP((-1) *Z))
Performance:
• The area under the ROC curve was 0.93.
To read more or access our algorithms and calculators, please log in or register.
Purpose: To evaluate a patient with acute liver failure using the prognostic model of Bhatia et al.
Specialty: Gastroenterology
Objective: severity, prognosis, stage
ICD-10: K72,
