The prognostic score developed at Hopital Erasme in Brussels, Belgium can be used to evaluate patients with hepatic cirrhosis. The authors that it predicted 1 year survival better than the Child-Pugh score.
Parameters:
(1) hepatic encephalopathy
(2) serum alkaline phosphatase
(3) serum total bilirubin
(4) serum cholinesterase
(5) serum total bile acids
|
Parameter |
Finding |
Score |
|
encephalopathy |
none |
1 |
|
|
grade I or II |
2 |
|
|
grade III or IV |
3 |
|
alkaline phosphatase in IU/L |
< 220 |
1 |
|
|
220 - 350 |
2 |
|
|
> 350 |
3 |
|
total bilirubin in mg/dL |
< 1.5 |
1 |
|
|
1.5 - 3.5 |
2 |
|
|
> 3.5 |
3 |
|
serum cholinesterase in IU/L |
> 3,000 |
1 |
|
|
1,800 - 3,000 |
2 |
|
|
< 1,800 |
3 |
|
serum bile acids in µmol/L |
< 35 |
1 |
|
|
35 - 110 |
2 |
|
|
> 110 |
3 |
combination score =
= (points for encephalopathy) + (points for alkaline phosphatase) + (points for total bilirubin) + (points for cholinesterase) + (points for bile acid)
Interpretation:
• minimum score: 5
• maximum score: 15
• An Erasme score > 10 indicates that 1 year survival is poor (approximately 15%), while survival with scores <= 10 was about 95%.
• For 1 year survival, the sensitivity of Erasme score versus Child-Pugh score was 82% vs 95%, with specificity 89% vs 56%.
Specialty: Gastroenterology
