TABLE 8. Prognostic indices for patients with idiosyncratic DILI.
Model/parameter | Model components | Proposed thresholds for liver transplant/death | Comments |
---|---|---|---|
MELD score143 | Bilirubin, INR, and creatinine | AUROC = 0.83 | Developed for cirrhosis patients |
Hy's law145 | ALT > 3× ULN and bilirubin > 2.5 mg/dl | PPV = 8%–20% | ALP should be < 2× ULN; not applicable to mixed/cholestatic cases |
Modified Hy's law144 | R‐value > 5 and bilirubin > 2.5 mg/dl | PPV = 12%; AUROC = 0.73 | |
Charlson Comorbidity Index and labs146 a | MELD score, albumin, Charlson > 2 | AUROC = 0.89 | Discovery and validation cohort used for 6‐month mortality |
Abbreviations: AUROC, area under the receive operating curve; MELD, Model for End‐Stage Liver Disease; PPV, positive predictive value.
Web‐based mortality calculator available at http://gihep.com/calculators/hepatology/dili‐CAM/.