Hepatogastroenterology 1998 Jan;45(19):160-169
Liver damage score--a new index for evaluation of the severity of chronic
liver diseases.
Krastev Z
Clinic of Gastroenterology, University Hospital St. Ivan Rilsky, Medical University,
Sofia.
BACKGROUND/AIMS:
Many hepatologists believe that the Child's classification is not the ultimate
prognostic tool for liver disease. Our aim was to develop an index for the estimation
of the severity of liver damage, to evaluate its predictive power for the short-term
and long-term prognosis of patients with chronic liver disease, and for the
estimation of the effect of different therapeutic regimens.
METHODOLOGY:
The Liver Damage Score (LDS) was developed based on the analysis of the laboratory
data of 151 randomly selected patients with liver diseases. Variables for reduced
protein synthesis, increased production of antibodies, cytolysis, cholestasis,
functional renal failure were combined into LDS according to the results of
cluster analysis. The evaluation of the liver injury was analyzed in 696 patients
with different liver diseases.
RESULTS:
There are three groups of liver diseases: mild-with LDS of 1-2 U, moderate
with LDS 3-4.5 U and severe with LDS > 5.0 U. There was a good correlation
between the LDS and the scores for liver cirrhosis. Values above 4-6 U carry
bad prognosis. The LDS truthfully reflects the evolution of liver diseases over
time and the effect of therapy.
CONCLUSION:
The LDS is a new, simple, low-cost, biomathematically and pathophysiologically
based index, useful for monitoring practically all patients with liver diseases,
no matter what the etiology and stage of the liver injury is. It allows a quantitative
expression of the disease severity and the improvement or deterioration in its
course.
PMID: 9496507, UI: 98157592
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