Klasifikasi Sirosis Hepatis
Multiple scores have been created to categorize the severity of disease. The Child-Pugh score is the most widely used. It incorporates three laboratory values (PT, bilirubin, and albumin) and two clinical features (ascites and encephalopathy). Class A patients have an 85% 2-year survival, compared with 60% and 35% for classes B and C, respectively.
The MELD (Model for End-stage Liver Disease) score has now supplanted the Child-Pugh classification for listing the patient for liver transplantation and is calculated by a formula that includes bilirubin, creatinine, and the INR instead of PT.
The MELD (Model for End-stage Liver Disease) score has now supplanted the Child-Pugh classification for listing the patient for liver transplantation and is calculated by a formula that includes bilirubin, creatinine, and the INR instead of PT.
The Child-Pugh score
| Bilirubin (mg/dL) | <2.0 | 2.1–3.0 | >3.0 |
| Prothrombin time (seconds prolonged) | <4 | 4–6 | >6 |
| Albumin (g/L) | >3.5 | 2.8–3.5 | <2.8 |
| Ascites | None | Mild–moderate | Severe |
| Encephalopathy | None | Mild–moderate | Severe |
Notes:
Child's class A: 5–6
Child's class B: 7–9
Child's class C: 10–15
The MELD score
MELD Score = 11.2 ln (INR) + 3.78 ln (bilirubin) + 9.57 ln (creatinine) + 6.43
MELD Score = 11.2 ln (INR) + 3.78 ln (bilirubin) + 9.57 ln (creatinine) + 6.43
| <10 | 2%–8% |
| 10–19 | 6%–29% |
| 20–29 | 50%–76% |
| 30–39 | 62%–83% |
| ≥40 | 100% |
Referensi:
Conn's Current Therapy 60th Edition (Saunders) 2008
Conn's Current Therapy 60th Edition (Saunders) 2008