El-Sharif et al reported the BE3A score for evaluating a patient with cirrhosis related to hepatitis C. This can help to identify a patient who is likely to benefit most from therapy with a direct-acting antiviral regimen. The authors are from St. James's Hospital Dublin, Beth Israel Deaconess Medical Center, University of Michigan, Gilead Sciences, University of Chicago, University of California San Francisco and Hannover Medical School.
Patient selection: decompensated cirrhosis associated with hepatitis C
Outcome: achievement of Child-Pugh-Turcotte (CPT) grade A cirrhosis
Parameters:
(1) body mass index in kg per square meter
(2) hepatic encephalopathy
(3) ascites
(4) serum ALT in IU/L
(5) serum albumin in g/dL
Parameter
Finding
Points
body mass index
< 25 kg per sq m
1
>= 25 kg per sq m
0
encephalopathy
no
1
yes
0
ascites
no
1
yes
0
serum ALT
<= 60 IU/L
0
> 60 IU/L
1
serum albumin
<= 3.5 g/dL
0
> 3.5 g/dL
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the greater the chances of reaching a CPT A.
Score
Percent CPT at 36 weeks
0
4%
1
20%
2
46%
3
56%
4 or 5
68%
Performance:
• The area under the ROC curve is 0.75.
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