EVALUATION OF LIVER FAILURE STAGE IN CHILDREN

Aim: to develop a system of evaluation of liver failure stage in children based on the International classification of functioning, disability and health (ICF). Patients and methods: based on the retrospective analysis of 14 biochemical markers, characterizing hepatic role in proteins, lipids and carbohydrates metabolism, of 115 children without liver diseases, 15 children who died of liver failure and 220 patients with various hepatic disorders, being followed-up in the SCCH of RAMS, a score system of evaluation of liver failure stage in children as an additional diagnostic tool was developed. Each of the biochemical markers was assessed according to the 5-point rating scale in dependence of its changes intensity. Results: the sum of points was considered to be a criterion of liver failure stage. According to the ICF recommendations, decrease of points on 0–4% (54–56 points) corresponds with absence of liver failure; 5–24% (43–53 points) — as mild dysfunction, 25–49% (29–42 points) — as moderate; 50-95% (3–28 points) — as severe; and 96–100% (0-2 points) — as absolute failure. Conclusions: score system of evaluation of liver failure stage can be applied at any step of diagnostics and treatment of children of any age, due to independence of the used markers from the age. It can be used in assessment of the severity of disorder in dynamics, in determination of the prognosis and as criterion of indications to liver transplantation, as well as during medico-social examination.

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