Predicting One Year Survival in Patients with Nonbiliary Hepatic Parenchymal Cirrhosis
Purpose: To estimate the one year survival rate for a patient with nonbiliary hepatic cirrhosis based on the degree of ascites and the aminopyrine breath test.
The probability of survival at 1 year in patients with nonbiliary hepatic cirrhosis can be estimated from the degree of ascites and the aminopyrine breath test. This can be used to assess patients for liver transplantation.
Development:
(1) This score was developed by the Medical-Surgical Department of Gastroenterology and Nephrology at the Hopital Erasme in Brussels, Belgium (see Erasme score, above).
(2) 91 consecutive patients were evaluated with variables analyzed using stepwise logistic regression analysis.
LN ((probability of survival) / (1 - (probability of survival))) =
• ascites score = 0 if absent, 1 if moderate and 2 if severe
• percent aminopyrine = percent aminopyrine activity of administered dose at 2 hours during an aminopyrine breath test
• The aminopyrine breath test involves the oral administration of carbon-14 aminopyrine with collection of carbon dioxide. The radioactivity of expired carbon dioxide versus the administered dose indicates the fraction of expired aminopyrine, from which the percent can be calculated.
• Normal values for the aminopyrine breath test is > 4.5% at 2 hours. Persons with cirrhosis tend to have values < 2.5% and patients with severe cirrhosis may have values < 1%.
If the equation is rearranged, then
probability of survival at 1 year =
= EXP(Z) / (1 + EXP(Z))
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Purpose: To estimate the one year survival rate for a patient with nonbiliary hepatic cirrhosis based on the degree of ascites and the aminopyrine breath test.
