Malatack et al developed a score for predicting the mortality risk by 6 months in a child with end-stage liver disease. This can help prioritize children for liver transplantation. The authors are from the Universities of Pittsburgh and Nebraska.
Parameters:
(1) serum total cholesterol
(2) history of ascites
(3) serum indirect bilirubin
(4) PTT
Parameter
Finding
Points
serum total cholesterol
>= 100 mg/dL
0
< 100 mg/dL
+15
history of ascites
absent
present
serum indirect bilirubin
< 3 mg/dL
3 – 6 mg/dL
+11
> 6 mg/dL
+13
PTT – (upper limit of control)
> 20 seconds
+10
<= 20 seconds
where:
• indirect bilirubin = (total serum bilirubin) – (direct bilirubin)
prognostic score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 53
• The higher the score, the worse the prognosis.
Score
Risk for Death in 6 Months
0 – 27
low
28 – 39
moderate
>= 40
high
• In the original table there is overlap between low and moderate risk at 28 points. I changed the upper limit of the low risk range to 27.
To read more or access our algorithms and calculators, please log in or register.
Purpose: To evaluate a child with progressive liver disease for mortality risk, to help prioritize patients for liver transplantation.
Specialty: Gastroenterology
Objective: severity, prognosis, stage
ICD-10: K72, K76.7,
