Van Vugt identified risk factors for mortality of a patient with cirrhosis who is waiting for a liver transplant. The authors are from Erasmus MC University, Leiden University, and the University of Groningen in The Netherlands.
Patient selection: adult with cirrhosis on the transplant waiting list
Outcome: 3-month mortality
Parameters:
(1) MELD score, from 5 to 50
(2) sarcopenia (skeletal muscle index for males with BMI < 25: < 43 square cm per meter squared; for males with BMI >= 35: < 53 square cm per meter squared; for females: < 41 square cm per meter squared)
(3) hepatic encephalopathy before listing
(4) age in years (from 15 to 70 years)
points for age from 15 to 70 years =
= (0.42181818 * (age)) - 6.32726
points for MELD from 5 to 50=
= (2.22*(MELD))-11.1
Parameter
|
Finding
|
Points
|
sarcopenia
|
absent
|
0
|
|
present
|
8.3
|
hepatic encephalopathy
|
absent
|
0
|
|
present
|
14
|
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 145.5
• The higher the score the greater the mortality rate.
Score
|
3-Month Mortality
|
< 23.2
|
0
|
23.2 to 121.5
|
(0.3196* (score)) - 7.836
|
> 121.5
|
> 30%
|
Performance:
• The area under the ROC curve is 0.85.