King's Score for Predicting Cirrhosis in Patient with Chronic Hepatitis C (HCV)

 

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

 

Parameters:

(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)

 

Interpretation:

• 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

 

Performance:

• 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.