Wu et al reported a modified SOFA score for a patient with hepatitis B virus (HBV)-related liver disease. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in China.
Patient selection: HBV-related liver disease
Parameters:
(1) serum creatinine in µmol/L (measure of renal function)
(2) grade of hepatic encephalopathy (HE, as a measure of CNS function)
(3) mean arterial pressure in mm Hg (MAP, as a measure of cardiac function)
(4) PaO2/FIO2 ratio or SpO2 to FIO2 ratio (as a measure of respiratory function)
Parameter
Finding
Points
serum creatinine
<= 103 µmol/L
1
104 to 206 µmol/L
2
>= 207 µmol/L
3
hepatic encephalopathy
grade 0
1
grade 1 or 2
2
grade 3 or 4
3
mean arterial pressure
>= 70 mm Hg
1
< 70 mm Hg
2
vasopressors required
3
PaO2 to FIO2 ratio
> 300 (SpO2/FIO2 > 357)
1
201 to 300 (SpO2/FIO2 215-357)
2
<= 200 (SpO2/FIO2 <= 214)
3
score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 4
• maximum score: 12
• The higher the score the more severe the illness.
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