### Description

Ekindjian et al developed a prognostic score for patients with cirrhosis. They used discriminant analysis to compare clinical and laboratory findings in patients who survived with those who died. The authors are from the Hopital A. Chenevier in Creteil and the University of Paris in France.

Patients: All of the patients were adults, with most having alcoholic cirrhosis.

Parameters:

(1) total serum bilirubin

(2) encephalopathy

(3) Factor 5 level

(4) serum AST (SGOT)

(5) antithrombin III level

(6) transferrin

 Parameter Finding Death Points total bilirubin > 55 µmol/L -1,796 <= 55 µmol/L 699 encephalopathy present -343 absent 443 Factor 5 levels > 27% 255 <= 27% -660 serum AST > 43 IU/L -281 <= 43 IU/L 269 antithrombin III level > 39% 308 <= 39% -312 transferrin > 1.65 g/L 452 <= 1.65 g/L -184

from Table 3, page 216

total death score =

= SUM(death points for all 6 parameters)

 Parameter Finding Survival Points total bilirubin > 55 µmol/L 688 <= 55 µmol/L -152 encephalopathy present 199 absent -66 Factor 5 levels > 27% -3 <= 27% 305 serum AST > 43 IU/L 178 <= 43 IU/L -7 antithrombin III level > 39% -21 <= 39% 188 transferrin > 1.65 g/L -69 <= 1.65 g/L 145

from Table 3, page 216

total survival score =

= SUM(survival points for all 6 parameters)

Interpretation:

• The patient's prognosis is determined as the lesser of the two scores.

• If the death score > survival score, then the patient will probably survive.

• If the death score < survival score, then the patient will probably die.

Limitations:

• Current therapies have improved survival since the study was done in 1981. However, it can still identify patients with a worse prognosis.