Evaluating prognosis

Liver related mortality is the eighth leading cause of death in the United States and is responsible for a significant proportion of premature mortality. Patients with cirrhosis can survive with compensated disease for several years or have evidence of decompensation, manifested by complications of portal hypertension. Prognosis depends of the clinical stage of disease, underlying disease process, clinical setting, and comorbidities. The Child-Pugh score, model for end-stage liver disease (MELD) score and its derivations, and the hepatic venous pressure gradient are helpful tools to assess prognosis. Disease-specific models are also helpful. Models that incorporate severity of multiple organ dysfunctions are helpful for patients in the intensive care unit or those with acute-on-chronic liver failure.