title: A predictive index for the diagnosis of cirrhosis in hepatitis C based on clinical, laboratory, and ultrasound findings.
abstract: OBJECTIVE
  To develop and validate a non-invasive index to predict the presence of cirrhosis in patients with chronic hepatitis C on the basis of clinical, laboratory, and ultrasound findings.
  
  
  METHODS
  Data from the complete history and physical examination, serologic studies, liver ultrasound, and liver biopsy of patients with chronic hepatitis C were analyzed using multivariate regression to develop a cirrhosis predictive index. This index was then applied prospectively to another group of patients with chronic hepatitis C to determine its accuracy.
  
  
  RESULTS
  Three hundred and thirty-two patients were included (mean age, 48.5+/-18.7 years; male-female ratio, 1.27). Sixty-seven patients (20%) had cirrhosis at histology. Logistic regression identified seven variables that predicted cirrhosis: age>or=60 years, platelet count<or=100 (x10/L), AST/ALT>or=1, prothrombin time (Ratio)>or=1.1, caudate hypertrophy, right lobe atrophy and splenomegaly. Patients scoring>or=22 in total had a statistically significant probability of cirrhosis (sensitivity, 80%; specificity, 96%; and diagnostic accuracy, 94%).
  
  
  CONCLUSIONS
  Cirrhosis can be predicted in patients with chronic hepatitis C by the evaluation of seven clinical, laboratory, and sonographic variables. The index will be useful for the management and follow-up of hepatitis C patients drastically reducing the indications for biopsy in this context.
authors.affiliation: Unitat de Malalties Digestives, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain. bdalmau@cspt.es
authors.forename: Blai Dalmau
authors.initials: BD
authors.lastname: Obrador
authors.forename: Montserrat Gil
authors.initials: MG
authors.lastname: Prades
authors.forename: Mercedes Vergara
authors.initials: MV
authors.lastname: Gómez
authors.forename: Jordi Puig
authors.initials: JP
authors.lastname: Domingo
authors.forename: Rosa Bella
authors.initials: RB
authors.lastname: Cueto
authors.forename: Montserrat
authors.initials: M
authors.lastname: Rué
authors.forename: Jordi
authors.initials: J
authors.lastname: Real
authors.forename: Pere Mas
authors.initials: PM
authors.lastname: Guiteras
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004812:Epidemiologic Methods; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000821:virology; D008111:Liver Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D010976:Platelet Count; D011379:Prognosis; D011517:Prothrombin Time; D018615:Ultrasonography, Doppler, Color
chemical_list: D015415:Biomarkers