Liver damage score--a new index for evaluation of the severity of chronic liver diseases.

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.