McMaster Textbook of Internal Medicine

Scoring systems for cirrhosis

2018-06-01

Pere Ginès

What prognostic tools or scoring systems are most useful in patients with cirrhosis?

Pere Ginès: This is a very interesting question. We have to differentiate 2 different areas, I would say. One is that of patients who have decompensated cirrhosis, and in this particular group of patients the best scores are the Model for End-Stage Liver Disease (MELD) score and Child-Pugh score. The MELD score includes a combination of 2 parameters of liver function, which are bilirubin and international normalized ratio (INR), and 1 parameter of renal function, which is serum creatinine. And the Child-Pugh score is very well known. These are the best for decompensated cirrhosis.

As for the group of patients with acute-on-chronic liver failure, there is a new score called the CLIF-C score, which combines the age of the patient, leukocyte number, and the function of 5 different organs, including the liver and extrahepatic organs. This is the best score for patients with acute-on-chronic liver failure.

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