Discriminant Score for Diagnosing Advanced Fibrosis or Cirrhosis

Objective: The aim of the study was to assess the utility of a modified three-parameter cirrhosis discriminant score (CDS) for diagnosing advanced fibrosis or cirrhosis in patients with evidence of chronic hepatitis C, Methods: We examined liver tissue from 79 patients, Patients with a histological fibrosis score of 0-2 made up group A, and patients with a score of 3 or 4 (advanced fibrosis or cirrhosis) group B.

Results: The modified CDS (possible total score 0-11) was derived from three laboratory parameters: platelets, ALT/AST ratio, and PT, The total score was significantly lower in group A (4.3 +/- 2.0) than in group B (7.9 +/- 1.4) (p < 0.0001), There was a positive correlation between the CDS and histological fibrosis score (r = 0,64,p < 0.0001), With 8 or above as the cutoff value, the CDS had a sensitivity of 46% and a specificity of 98 % for the diagnosis of histological fibrosis scores of 3 or 4.

Conclusions: We conclude that a three-parameter CDS is useful for identifying patients with hepatitis C and a high likelihood of cirrhosis, Patients with a CDS less than or equal to 7 still require histological examination to identify advanced fibrosis or cirrhosis.

Author: BONACINI M, UNIV SO CALIF, RANCHO LOS AMIGOS MED CTR, LIVER UNIT, BLDG 500, 7601 E IMPERIAL HIGHWAY DOWNEY, CA 90242
Source: AMERICAN JOURNAL OF GASTROENTEROLOGY 1997 AUG;92(8):1302-1304

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