Cross et al reported a score for predicting cirrhosis in a patient with chronic viral hepatitis C (HCV). The authors are from King's College Hospital and King's College in London.


Patient selection: chronic HCV


Outcomes: significant fibrosis defined as Ishak fibrosis F3 to F6 (range from 0 to 6), with cirrhosis defined as F5 or F6



(1) age in years

(2) AST in IU/L (Advia 2400, Siemens with reference range 10 to 50 IU/L)

(3) INR

(4) platelet count (factor * 10^9/L)


score =

= (age) * (AST) * (INR) / (platelet count factor)



• A score >= 16.7 was associated with cirrhosis in 34% of patients with an odds ratio of 36.2. The negative predictive value was 96%.

• A score >= 12.3 was associated with F3-F6 fibrossi with an odds ratio of 33.9



• Variation in the method for determining AST will affect performance.

• The area under the ROC curve is 0.79 for predicting of significant fibrosis and 0.91 for cirrhosis.


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