Risk Score of Bihari et al for Coagulopathic Bleeding in Decompensated Cirrhosis and Acute-on-Chronic Liver Failure (ACLF)

Description

Bihari et al reported a score for predicting coagulopathic bleeding in patient's with decompensated cirrhosis or acute-on-chronic liver failure (ACLF). This can help to identify a patient who may benefit from more aggressive management. The authors are from the Institute of Liver and Biliary Sciences in New Delhi

Parameters:

(1) activated clotting time in seconds from Sonoclot assay

(2) platelet function from Sonoclot assay

(3) fibrinogen in g/L

Parameter	Finding	Points
activated clotting time	< 190	1
	190 to 255	2
	> 255	3
platelet function	< 1.25	3
	>= 1.25	1
fibrinogen	< 1.2	3
	>= 1.2	1

total score =

= SUM(points for all 3 parameters)

Interpretation:

• minimum score: 3

• maximum score: 9

Score	Bleeding Risk	Bleeding Free at 1 Month
3 or 4	mild	84%
5 or 6	moderate	61%
7 to 9	severe	27%

Performance:

• The area under the ROC curve is 0.88.

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Risk Score of Bihari et al for Coagulopathic Bleeding in Decompensated Cirrhosis and Acute-on-Chronic Liver Failure (ACLF)

Description

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