Takikawa et al reported the Japanese Hepatic Encephalopathy Prediction Model (J-HEPM) for evaluating a patient with acute liver disease not due to paracetamol. It can be used to evaluate the prognosis for a patient with acute liver failure or acute-on-chronic liver disease. The authors are from Iwate Medical University and Kagoshima University in Japan.
Patient selection: symptomatic acute liver disease not due to paracetamol
Parameters:
(1) serum total bilirubin in mg/dL
(2) percent prothrombin time (as percent)
(3) age in years
(4) etiology
Parameter
Finding
Points
serum total bilirubin
0.692 * LN(1 + (STB)
prothrombin time
-0.065 * (PT)
age in years
<= 50 years
0
> 50 years
1.388
etiology
flare of chronic HBV, autoimmune hepatitis, unknown
0.868
all other
0
value of X =
= SUM(points for all of the parameters) - 1.156
probability of hepatic encephalopathy =
= 1 / (1 + EXP((-1) * X))
A patient with a high score requires more intensive care.
Performance:
• The area under the ROC curve is 0.89.
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