Hudson et al reported the Bristol Prognostic Score (BPS) for evaluating a patient with decompensated cirrhosis. This can help to identify a patient who is suitable for palliative care. The authors are from the University of Bristol.
Patient selection: decompensated cirrhosis
Parameters:
(1) ECOG performance status
(2) number of liver related admissions in the past year
(3) Child Pugh grade
(4) ongoing alcohol intake in a patient with alcoholic cirrhosis
(5) suitability for liver transplant
Parameter
Finding
Points
ECOG performance
0 to 2
0
3 or 4
1
liver related admissions
3 or more in past year
1
0 to 2 in past year
0
Child Pugh grade
A or B
0
C
1
ongoing alcohol intake
no
0
yes
1
suitability for transplant
no
1
yes
0
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• A score of 3 to 5 is associated with 1 year mortality and should prompt a referral for advanced care and palliative care.
• Bowers et al suggested using the Liver Frailty Index over the ECOG performance status.
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