Liu et al reported a model for predicting cirrhosis in a patient without chronic viral hepatitis who is an at-risk alcohol drinker. This can help to identify a patient who may benefit from an intervention to reduce the risk of cirrhosis. The authors are from Zhengzhou University, Hunan Cancer Hospital, and Peking Union Medical College in China.
Patient selection: at-risk alcohol drinker without HBV or HCV infection
At-risk drinking: >= 12 g of ethanol per week for >= 6 months (less than 1 standard drink per week)
Parameters:
(1) sex
(2) level of education
(3) dietary intake of vegetables in kilograms per week
(4) roughage intake in kilograms per week
(5) smoking index (cigarettes per day multiplied by years)
(6) number of years of secondhand smoke exposure
(7) fatty liver
(8) diabetes
(9) first-degree relative with liver cancer
Parameter
Finding
Points
sex
male
0
female
3
level of education
high
0
not high
1
dietary intake of vegetables
< 2.5 kg per week
2
>= 2.5 kg per week
0
roughage
< 0.5 kg per week
1
>= 0.5 kg per week
0
smoking index
0
0
1 to 399
3
>= 400
5
secondhand smoke
0 years
0
1 to 29 years
0
>= 30 years
3
fatty liver
no
0
yes
2
diabetes
no
0
yes
2
relative with liver cancer
no
0
yes
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
Score
Risk Category
OR for Cirrhosis
0 to 7
low
1
8 to 12
medium
2.1-2.3
13 to 20
high
6.0 to 7.4
Performance:
• The study mixes very low and very high drinkers together.
• The area under the ROC curve is 0.79.
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