LIVER-DAMAGE SCORE - A NEW INDEX FOR EVALUATION OF THE SEVERITY OF CHRONIC LIVER-DISEASES

Background/Aims: Many hepatologists believe that the Child's classific ation is not the ultimate prognostic tool for liver disease. Our aim w as to develop an, index for the estimation of the severity of liver da mage, to evaluate its predictive power for the short-term and long-ter m prognosis of patients with chronic liver disease, and for the estima tion 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-ant ibodies, cytolysis, cholestasis, functional renal failure were combine d into LDS according to the results of-cluster analysis. The evaluatio n of the liver injury was analyzed in 696 patients with different live r 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 l iver cirrhosis. Values above 4-6 U carry bad prognosis. The LDS truthf ully reflects the evolution. of liver diseases over time and the effec t of therapy. Conclusion: The LDS is a new simple, low-cost, bio-mathe matically and pathophysiologically based index, useful for monitoring practically all patients with liver diseases, no matter what the etiol ogy and stage of the liver injury is. It allows a quantitative express ion. of the disease severity and the improvement or deterioration, in its course.