Lal et al reported the Peds-HAV score for evaluating a pediatric patient with fulminant hepatitis A. This can help to identify a patient who may need a liver transplant. The authors are from the Institute of Liver and Biliary Sciences in New Delhi, India.
Patient selection: fulminant hepatitis A with age <= 18 years
Parameters:
(1) INR
(2) number of days between jaundice onset and hepatic encephalopathy
(3) hepatic encephalopathy Grade III or IV
Parameter
Finding
Points
INR
<= 3.1
0
> 3.1
1
number of days
<= 10 days
0
> 10 days
1
hepatic encephalopathy
Grade 0 to II
0
Grade III or IV
1
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• A patient with a score >= 2 should be placed on the liver transplant list.
Performance:
• The sensitivity is 90% and specificity 81%.
• The area under the ROC curve is 0.92.
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