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hepatic_function

assessment of hepatic function

evaluating hepatic function

  • unfortunately, there is no single test that measures liver function.

index of suspicion of impaired function from clinical history

clinical signs of liver disease

  • spider naevi
  • palmar erythema
  • ascites
  • abdominal distension
  • hepatomegaly
  • splenomegaly
  • caput medusa

further investigations if clinical evidence of liver disease

    • although not directly correlated with liver dysfunction, elevated liver enzymes may raise the suspicion of hepatic impairment
  • abdominal ultrasound with portal vein Doppler study to assess portal hypertension

Child-Pugh grading of hepatic dysfunction

parameter Points assigned = 1 Points assigned = 2 Points assigned = 3
ascites absent slight moderate
bilirubin micromol/L < 11 11-45 >45
albumin g/L > 35 28-35 < 28
INR <1.7 1.7-2.3 > 2.3
hepatic encephalopathy none grade 1-2 grade 3-4
Child-Pugh score grade of dysfunction 1 year survival 2 year survival
5-6 grade A or well compensated 100% 85%
7-9 grade B or significant functional compromise 80% 60%
10-15 grade C pr decompensated liver disease 45% 35%

NB. survival rates are for patients with alcoholic cirrhosis

alternative methods for assessing liver dysfunction

references and resources

hepatic_function.txt · Last modified: 2013/12/27 03:33 by gary1