Budd-Chiari syndrome: Prognostic scores, special populations, and management challenges

Table 1 Variables, formulas, and interpretation for each score

Score	Type	Parameters used	Formula/cutoffs	Clinical interpretation
New Clichy Score	Clinical/Laboratory-based	Bilirubin, INR, creatinine, ascites, encephalopathy	Weighted scoring system; score > 2 indicates poor prognosis	Stratifies diseases severity; guides timing of intervention
BCS-TIPS Index	Clinical/Laboratory-based	Bilirubin, INR, creatinine, age	Score = (1.03 × creatinine) + (0.8 × bilirubin) + (0.8 × INR) + (0.3 × age); > 7 Leads to poor outcome	Predicts survival after TIPS
Zeitoun Score	Clinical/Laboratory-based	INR, bilirubin, ascites	Categorical system: Class I (mild) to Class III (severe)	Assesses prognosis pre-TIPS
PELD Score	Clinical/Laboratory-based (pediatrics)	Albumin, bilirubin, INR, growth failure, age	Standard UNOS formula; higher scores correlate with worse outcomes	Used for pediatric LT prioritization
Imaging parameters	Imaging-based (proposed/research)	HV patency, caudate lobe hypertrophy, hepatic congestion signs	Standard UNOS formula; higher scores correlate with worse outcomes	Not part of current scores; proposed for future integration

BCS: Budd-Chiari syndrome; TIPS: Transjugular intrahepatic portosystemic shunt; PELD Score: Pediatric End-stage Liver Disease Score; INR: International normalized ratio; HV: Hepatic vein; LT: Liver transplantation; UNOS: United Network. for Organ Sharing.