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Risk Score of Bihari et al for Coagulopathic Bleeding in Decompensated Cirrhosis and Acute-on-Chronic Liver Failure (ACLF)

Description

Bihari et al reported a score for predicting coagulopathic bleeding in patient's with decompensated cirrhosis or acute-on-chronic liver failure (ACLF). This can help to identify a patient who may benefit from more aggressive management. The authors are from the Institute of Liver and Biliary Sciences in New Delhi


Parameters:

(1) activated clotting time in seconds from Sonoclot assay

(2) platelet function from Sonoclot assay

(3) fibrinogen in g/L

 

Parameter

Finding

Points

activated clotting time

< 190

1

 

190 to 255

2

 

> 255

3

platelet function

< 1.25

3

 

>= 1.25

1

fibrinogen

< 1.2

3

 

>= 1.2

1

 

total score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 3

• maximum score: 9

 

Score

Bleeding Risk

Bleeding Free at 1 Month

3 or 4

mild

84%

5 or 6

moderate

61%

7 to 9

severe

27%

 

Performance:

• The area under the ROC curve is 0.88.


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