ALPACA Score of Johansen et al for Predicting Liver-Related Events in a Patient with Alcoholic Liver Disease

ALPACA is derived from letters in "ALD for prognostics including platelets, AST/ALT and PRO-C3".

Liver-related events: hepatic encephalopathy, ascites, varices requiring treatment, episode of alcoholic hepatitis.

Time frame: 5 years

Parameters:

(1) serum PRO-C3 in ng/mL

(2) serum AST in U/L

(3) serum ALT in U/L

(4) platelet count in 10^9/L

AST to ALT ratio =

= (AST) / (ALT)

ALPACA score =

= (PRO-C3) * (AST to ALT ratio) * 100 / (platelet count)

Interpretation:

• A score <= 11 is low risk while a score > 11 is high risk.

Performance:

• The area under the ROC curve is 0.90.