PROGNOSTIC EVALUATION OF PATIENTS WITH PARENCHYMAL CIRRHOSIS - PROPOSAL OF A NEW SIMPLE SCORE

Background/Aims: The current shortage of organs makes it desirable to establish the prognosis of patients with cirrhosis in order to assess priority for liver transplantation. Methods: We compared the utility o f two exogenous tests (aminopyrine breath test and lidocaine metaboliz ation test), two clinical parameters (encephalopathy, ascites), 18 end ogenous tests and five scores (Pugh, Merkel, Orrego Adler, Pignon) for predicting 1-year mortality in patients with parenchymal cirrhosis, R etrospective (n=49 out of 63 patients) and prospective (n=38 out of 46 patients) series were included, Univariate, multivariate, receiver op erator curves and survival curves were employed. Results: We found tha t endogenous tests were more discriminant than exogenous tests, The be st parameters of the univariate analysis (encephalopathy, bilirubin, a lkaline phosphatase, cholinesterase and bile acids) and their 25th and 75th percentiles were included in an additive new score which turned out to be superior to the five other scores, Prospectively, the sensit ivity of our new score compared to the Pugh score was 82% versus 95% ( NS) and the specificity was 89% versus 56% (p<0.01). Conclusions: Our new simple score appears to be very powerful for predicting prognosis at 1 year for patients with cirrhosis and should be evaluated in other centers.