Estimation of Short‐Term Prognosis in Advanced Liver Disease

Review Article

Estimation of Short‐Term Prognosis in Advanced Liver Disease

Rudolf E Stauber

Affiliation:  Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria


ABSTRACT

Short‐term prognosis in advanced liver disease may be estimated by liver‐specific prognostic models, such as the Child–Pugh score, the model for end‐stage liver disease (MELD) score and Na‐containing models, or by general intensive care unit (ICU) prognostic models such as the acute physiology and chronic health evaluation (APACHE) scores and the sequential organ failure assessment (SOFA) score. The general ICU prognostic models proved superior to the liver‐specific models in critically ill cirrhotic patients admitted to the ICU. Indocyanine green clearance was proposed as a quantitative liver function test several decades ago and may now be measured non‐invasively by finger‐pulse densitometry; however, its diagnostic accuracy was found to be inferior to that of MELD in decompensated cirrhosis.

Keywords: chronic liver failure, acute‐on‐chronic liver failure, decompensated cirrhosis, liver transplantation, Child–Pugh score, MELD score, SOFA score, APACHE II score, APACHE III score

Correspondence: Rudolf E Stauber, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, A‐8036 Graz, Austria. Tel: (43)‐316‐385‐80268; Fax: (43)‐316‐385‐2648; e‐mail: rudolf.stauber@medunigraz.at