Alcoholic Liver Disease Combined Index Criteria for One Year Mortality
Info
Encephalopathy Yes No
Ascites Yes No
>10 spider nevi Yes No
Weakness Yes No
Anorexia Yes No
Alkaline Phos >330 U/L Yes No
Collateral circulation None Grade 1-2 Grade 3
Edema None Grade 1 Grade 2-3
Protime prolongation < 4 4-5 seconds > 5 seconds
Hematocrit % of normal >=90 75-89.9 < 75
Albumin >2.9 gm/dL (>29 gm/L) 2.5-2.9 gm/dL (25-29 gm/L) < 2.5 gm/dL (< 25 gm/L)
Bilirubin <2.1 mg/dL (<36 µmol/L) 2.1 - 8 mg/dL (36-136. 8 µmol/L) > 8 mg/dL (>136.8 µmol/L)
R e s u l t s
Mortality at 1 year
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Alcoholic Liver Disease Combined Index Criteria for One Year Mortality

This calculator predicts mortality at 1 year in patients with alcoholic liver disease and is based upon both clinical and laboratory factors.

The questions, scoring and interpretation is as follows:

Item/Factor: Points if present

  • Encephalopathy: 2
  • Ascites: 2
  • >10 spider nevi: 1
  • Weakness: 1
  • Anorexia: 1
  • Alkaline Phos >330 IU/dL: 2

Collateral circulation

  • Grade 1-2: 1
  • Grade 3: 3

Edema

  • Grade 1: 1
  • Grade 2-3: 0

Protime prolongation

  • 4-5 seconds: 1
  • 5 seconds: 2
  • <4 seconds: 0

Hematocrit % of normal

  • 75-89.9: 1
  • <75: 3
  • 89.9: 0

Albumin

  • 2.5-2.9 gm/dL: 2
  • <2.5 gm/dL: 3
  • 2.9 gm/dL: 0

Bilirubin

  • 2.1 - 8 mg/dL: 2
  • 8 mg/dL: 3
  • <2.1 mg/dL: 0

Interpretation:

Points: Mortality in 1 year

  • 0: 0%
  • 1-5: ~7%
  • 6-10: ~20%
  • 11-15: ~58%
  • 16-20: ~90%
  • 21-25: ~100%

Note that the encephalopathy grading is that of Adams and Foley:

  • Grade I Euphoria or depression, mild confusion, monotonous voice and/or sleep cycle disorders, ±asterixis.
  • Grade II. Lethargy and/or confusion, asterixis, triphasic waves on EEG.
  • Grade III. Severe confusion, incoherent language, semi-stupor but awakes with language, asterixis, triphasic waves on EEG.

Reference:

  1. Orrego H, Israel Y, Blake JE, Medline A. Assessment of prognostic factors in alcoholic liver disease: toward a global quantitative expression of severity. Hepatology. 1983;3(6):896-905.