Blood ammonia levels in liver cirrhosis: a clue for the presence of portosystemic collateral veins

BMC Gastroenterology

Table 1 Child-Pugh classification slightly modified.

Clinic and laboratory data	Points for increasing abnormality¹
	1	2	3
HE (grade ² )	None	SHE (0), 1–2	3–4
Ascites	None at US	Mild or controlled by diuretics	Present despite diuretics
PT (% of activity) ³	> 70	70–40	< 40
Albumin (g/dL)	> 3.5	2.8–3.5	< 2.8
Bilirubin (mg/dL)	< 2	2–3	> 3

¹Scoring system: 5–6 points, grade A; 7–9 points, grade B; 10–15 points, grade C. ²HE: hepatic encephalopathy; Grade 0: sub-clinical hepatic encephalopathy, SHE, unravelled by Retain tests A or B; Grade 1: anxiety, irritability, depression, impaired concentration, sleep disturbances; Grade 2: disorientation, poor short-term memory, disinhibited behavior, drowsiness; Grade 3: somnolence, bizarre behavior, confusion, amnesia, paranoia; Grade 4: Coma. ³PT, prothrombin time, also expressed in seconds prolonged < 4; 4–6; > 6, or as INR < 1.7; 1.7–2.3; > 2.3. US: ultra sound

ISSN: 1471-230X