The Royal Free Hospital Score for Predicting Mortality of a Patient with Cirrhosis Admitted to the ICU (RFH Score)

 

Patient selection: patient with cirrhosis admitted to the ICU

 

Parameters on day of ICU admission:

(1) variceal bleeding

(2) serum total bilirubin in µmol/L

(3) INR

(4) serum urea in mmol/L (the paper makes reference to µmol/L)

(5) lactate in mmol/L

(6) A-a gradient (alveolar-arterial partial pressure oxygen gradient) with PaO2 in kPA)

 

RFH score =

= (0.003 * (serum total bilirubin)) + (0.358 * (INR)) + (0.136 * (lactate)) + (0.004 * (A-a gradient)) + (0.036 * (urea)) – (0.996 if variceal bleeding present)) – 2.692

 

Interpretation:

• A score >= -0.82 was associated with increased mortality.

 

Performance:

• The sensitivity was 86% and specificity 59%.

• The positive predictive value was 71% and negative predictive value 78%.