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King's Score: an accurate marker of cirrhosis in chronic hepatitis C

Timothy J S Cross1, Paolo Rizzi, Philip A Berry

  • 1Institute of Liver Studies, King's College Hospital, Denmark Hill, London, UK.

European Journal of Gastroenterology & Hepatology
|May 12, 2009
PubMed

Insights

A new King's Score effectively predicts significant liver fibrosis and cirrhosis in chronic hepatitis C patients. This simple index aids in identifying individuals at low risk for advanced liver disease, reducing the need for routine biopsies.

Area of Science:

  • Hepatology
  • Medical Diagnostics
  • Biostatistics

Background:

  • Histological assessment for chronic hepatitis C (HCV) is no longer routine.
  • A simple, non-invasive method is needed to identify significant hepatic fibrosis in HCV patients.

Purpose of the Study:

  • To develop and validate a simple clinical index for predicting significant hepatic fibrosis and cirrhosis in patients with chronic hepatitis C.

Main Methods:

  • Retrospective data collection from 923 chronic hepatitis C patients undergoing liver biopsy.
  • Multivariate analysis to identify factors associated with fibrosis.
  • Construction and validation of the King's Score using training (602 patients) and validation (105 patients) sets.

Main Results:

  • The King's Score (age x AST x INR / platelets) accurately predicted cirrhosis (AUC 0.91) and significant fibrosis (F3-6, AUC 0.79) in the training set.
  • A King's Score ≥16.7 predicted cirrhosis with 86% sensitivity and 80% specificity.
  • Validation set confirmed high predictive accuracy (AUC 0.94 for cirrhosis, 0.89 for F3-6).

Conclusions:

  • The King's Score is a simple, accurate, and validated index for predicting cirrhosis in chronic hepatitis C.
  • Patients with a King's Score <16.7 have a low risk of cirrhosis, potentially avoiding liver biopsy.
Abstract

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