Complications of end-stage liver disease

Giulia-Anna Perri; Houman Khosravani

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Table 1.

West Haven Criteria for altered mental state in hepatic encephalopathy

STAGE	DESCRIPTION
Grade I	Trivial lack of awareness Euphoria or anxiety Shortened attention span Impairment of addition or subtraction Altered sleep rhythm
Grade II	Lethargy or apathy Disorientation for time Obvious personality change Inappropriate behaviour Dyspraxia Asterixis
Grade III	Somnolence or semistupor Responsive to stimuli Confused Gross disorientation Bizarre behaviour
Grade IV	Coma

Data from Vilstrup et al.⁶

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Table 2.

Child-Pugh classification of severity of cirrhosis: A total score of 5 to 6 is considered class A (well compensated disease); 7 to 9 is class B (substantial functional compromise); and 10 to 15 is class C (decompensated disease).

PARAMETER	POINTS ASSIGNED

	1	2	3
Ascites	None	Mild or moderate	Tense
Bilirubin level, μmol/L	< 34.2	34.2 to 51.3	> 51.3
Albumin level, g/L	> 35	28 to 35	< 28
Prolonged prothrombin time, s	< 4	4 to 6	> 6
INR	< 1.7	1.7 to 2.3	> 2.3
Hepatic encephalopathy	None	Grade I to II	Grade III to IV