Description

The short term prognosis in patients with portal hypertension and esophageal varices who present with acute variceal hemorrhage can be predicted from a limited number of factors. These were identified by univariate analysis and shown to be independent by stepwise logistic regression. The probability equation is used as the measure of liver failure in the Organ Failure Score.


 

Parameters associated with probability of discharge from hospital:

(1) prothrombin time

(2) serum creatinine

(3) presence or absence of encephalopathy

 

log ((probability of discharge) / (1 - (probability of discharge))) =

= X =

= 100 - (4.3 * (prothrombin time ratio)) - (0.03 * (serum creatinine in mg/dL) * 88.4) - (0.85 * (-1 if encephalopathy is absent, +1 if present))

 

where:

• prothrombin ratio = (patient's prothrombin time in seconds) / (mean prothrombin time for normal plasma)

• 88.4 is conversion for creatinine in mg/dL to SI units

 

The base of the logarithm is not given. Since the usual format for a logit expression uses the natural logarithm, this will be used as the preferred expression.

 

If the expression is rearranged, it becomes:

 

probability of discharge =

= (EXP (X)) / (1 + (EXP (X)))

 

Performance:

• The equation predicted outcome in 90% of admissions.

 


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