Hepatic Disease Score Calculator for Argatroban Dosing

Bilirubin (mg/dl):  <2    OR < 4 for patients with primary biliary cirrhosis    (1 point)
   2-3   OR 4-10 for patients with primary biliary cirrhosis  (2 points)
   >3    OR > 10 for patients with primary biliary cirrhosis  (3 points)
   
Albumin (g/dl):  >3.5      (1 point)
 3.5-2.8  (2 points)
 <2.8      (3 points)
   
PT prolongation (INR):  <4 seconds (<1.7)        (1 point)
 4-6 seconds (1.7-2.3)   (2 points)
 >6 seconds (>2.3)        (3 points)
   
Ascites:  Absent      (1 point)
 Slight         (2 points)
 Moderate  (3 points)
   
Encephalopathy:  Absent              (1 point)
 Mild (I-II)         (2 points)
 Severe (III-IV)  (3 points)

Hepatic Disease Score:   If greater than 6 argatroban starting dose should be reduced to 0.5 mcg/kg/min
Interpretation:
Class A: 5-6
Class B: 7-9
Class C: 10-15

Stages of Hepatic Encephalopathy

    Stage 1: Euphoria or depression, mild confusion, slurred speed, disordered sleep

    Stage 2: Lethargy, moderate confusion

    Stage 3: Marked confusion, incoherent speech, sleeping but arousable

    Stage 4: Coma, initially responsive to noxious stimuli, but later unresponsive