Chronic Liver Disease Prognostic Tools

Common tools used to assess the prognosis of chronic liver disease (CLD) include:

• Child-Turcotte-Pugh classification is a validated tool used to predict the risk of mortality and other complications for patients with liver disease after major surgery. This system categorizes liver disease severity into 3 classes (based on the sum of values assigned to factors: bilirubin, albumin, INR, ascites, and encephalopathy. It helps predict short-term survival and guides treatment decisions. https://www.hepatitis.va.gov/cirrhosis/background/child-pugh-calculator.asp
  
• Model for End-Stage Liver Disease (MELD) Score: This score incorporates serum creatinine, bilirubin, INR, and sodium levels to estimate 3-month mortality risk. It's particularly useful for prioritizing liver transplant candidates. https://www.hepatitis.va.gov/cirrhosis/background/cirrhosis-meld-score.asp 
• MELD-Na Score: This is a modification of the MELD score that includes sodium levels, which are associated with increased mortality risk in patients with cirrhosis.  
• Fibrosis-4 (FIB-4) Index: This non-invasive blood test uses age, weight, platelet count, and liver enzymes to estimate liver fibrosis (scarring) and predict the risk of liver disease progression. https://pmc.ncbi.nlm.nih.gov/articles/PMC8700445/ 
• Liver stiffness measurement (Fibroscan, transient elastography): This non-invasive test uses ultrasound waves to measure liver stiffness, which correlates with fibrosis stage. https://pmc.ncbi.nlm.nih.gov/articles/PMC10086842/ 
• Liver biopsy: This invasive procedure involves removing a small piece of liver tissue for microscopic examination to assess fibrosis stage, inflammation, and other features.

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