Liu et al reported a score for stratifying the risk of hepatic decompensation for a patient with advanced liver disease. The authors are from multiple institutions in China, Japan, Korea, Singapore, India and Egypt.
Patient selected: compensated advanced liver disease
Parameters:
(1) liver stiffness in kPa
(2) platelet count in 10^9/L
(3) serum albumin in g/L
(4) serum ALT in U/L
(5) varices
Parameter
Finding
Points
liver stiffness
0.036* (stiffness)
platelet count
-0.013 * (platelet count)
serum albumin
-0.068 * (albumin)
serum ALT
-0.016 * (ALT)
varices
absent
0
present
0.651
total score =
= SUM(points for all of the parameters)
Total Score
Risk Category
< -4.4
low
-4.4 to -3.1
medium
> -3.1
high
Performance:
• The area under the ROC curve was 0.85 in the derivation and 0.84 in validation cohorts.
• The high-risk category had a positive predictive value of 0.93 for clinically significant portal hypertension.
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