5.1 Prognostic scores

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The severity of liver disease was previously mainly assessed using the so-called Child-Pugh score. This score is determined by the presence of ascites, hepatic encephalopathy, severity of jaundice, severity of hypoalbuminemia and severity of the disturbed PT. Three groups are distinguished: Child A (best prognosis), Child B and Child C (worst prognosis). The Child-Pugh score was previously developed to estimate the mortality of a laparotomy (Child A: <5%, Child B: 25% and Child C: 50%).

The most objective score that is mainly used today is the MELD score. It is based on the INR, bilirubin and creatinine. The score ranges from 6 to 40. It gives a very accurate estimate of short-term survival in most causes of cirrhosis.

Another prognostic score is the frailty index. Weakness occurs in 30 to 40% of patients with cirrhosis. This weakness is caused by malnutrition and muscle wasting and determines the prognosis. For cirrhosis patients, there is a specific liver frailty index (Liver Frailty Index). This consists of the results of grip strength, the ability to 'sit' and a balance test.

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