GI & Hepatology Calculators

Identifies upper GI bleed patients safe for outpatient management. Score 0 has very low risk.

Predicts rebleeding and mortality after upper GI haemorrhage following endoscopy.

Assesses severity of chronic liver disease and cirrhosis. Guides prognosis and surgical risk.

Model for End-stage Liver Disease. Predicts 3-month mortality. Used for liver transplant prioritisation.

MELD incorporating serum sodium. Better predictor of 3-month transplant waitlist mortality than MELD alone.

Predicts severity of acute pancreatitis. Criteria assessed at admission and at 48 hours.

Non-invasive assessment of liver fibrosis in chronic liver disease (NAFLD, hepatitis B/C).

Assesses severity of acute pancreatitis using 8 criteria within 48 hours of admission.

Predicts in-hospital mortality and need for ICU admission in upper GI bleeding. Simpler than Glasgow-Blatchford; uses 5 binary variables obtainable at triage.

Bedside Index for Severity in Acute Pancreatitis (BISAP). Simple 5-point score calculated within 24h of admission to predict in-hospital mortality.

Predicts 30-day mortality in alcoholic hepatitis and identifies patients who benefit from corticosteroid therapy (prednisolone). DF ≥ 32 indicates severe disease.

Assesses response to corticosteroid therapy in severe alcoholic hepatitis at Day 7. Lille score > 0.45 predicts non-response — steroids should be stopped.

Non-invasive score to identify significant fibrosis (F2–F4) or cirrhosis in patients with non-alcoholic fatty liver disease (NAFLD/MASLD), potentially avoiding liver biopsy.

Non-invasive marker of hepatic fibrosis and cirrhosis, most validated in chronic hepatitis C. Also used in NAFLD, hepatitis B, and alcoholic liver disease.

Differentiates portal hypertension-related (transudative) from non-portal hypertension (exudative) causes of ascites. SAAG = serum albumin − ascites albumin.

Endoscopic classification system for upper GI bleeding lesions based on stigmata of recent haemorrhage. Guides re-bleeding risk and need for endoscopic therapy.

Grades hepatic encephalopathy severity using the West Haven criteria (Grades 0–4), guiding management intensity in patients with liver disease.

Simplified clinical index for assessing Crohn's disease activity. Simpler bedside alternative to the CDAI, using 5 clinical variables.

Assesses ulcerative colitis (UC) disease activity using clinical and endoscopic findings. Guides treatment decisions including steroid use and biologics.

Barcelona Clinic Liver Cancer (BCLC) staging system — the most widely used HCC staging and treatment allocation tool, endorsed by EASL and AASLD.

Rome IV diagnostic criteria for IBS: recurrent abdominal pain ≥ 1 day/week for 3 months, associated with defaecation or stool change.

Predicts 6-week rebleeding and mortality risk after acute oesophageal variceal haemorrhage to guide intensity of follow-up and secondary prophylaxis.

Appendicitis Inflammatory Response (AIR) score — validated tool for stratifying patients with suspected appendicitis. Score 0–12.

Updated MELD score incorporating sex (MELD 3.0) for more equitable liver transplant allocation. Approved by UNOS in 2022.

Predicts in-hospital mortality in patients with acute upper GI bleeding. Components: general health status, INR, albumin, mental status, BP, endoscopy diagnosis.

Identifies patients with acute liver failure (ALF) who require urgent liver transplant listing. Separate criteria for paracetamol (acetaminophen) and non-paracetamol aetiology.

Diagnostic criteria for spontaneous bacterial peritonitis (SBP) in cirrhotic ascites. PMN count from diagnostic paracentesis is the gold standard.

Modified clinical scoring system for acute appendicitis diagnosis in adults. Score 0–10.

Age, serum Bilirubin, INR, and serum Creatinine (ABIC) score predicts 90-day mortality in alcoholic hepatitis. Identifies low-, intermediate-, and high-risk patients.

Predicts 28-day mortality in alcoholic hepatitis. Score ≥9 identifies patients likely to benefit from corticosteroids.

Identifies patients with harmless acute pancreatitis who can be managed without intensive monitoring. All three negative criteria must be absent to classify as harmless.

Chronic Liver Failure Consortium — ACLF score predicts 28-day and 90-day mortality in acute-on-chronic liver failure (ACLF). Based on organ failure count, age, WBC, and creatinine.

Predicts 30-day hospital readmission in cirrhotic patients following discharge. Identifies high-risk patients who may benefit from closer follow-up.

Classifies drug-induced liver injury (DILI) as hepatocellular, cholestatic, or mixed based on the pattern of liver enzyme elevation. Used in CIOMS/RUCAM assessment.

Predicts hepatic steatosis (fatty liver) using BMI, waist circumference, triglycerides, and GGT. Validated as a non-invasive screening tool for NAFLD.

Albumin-Bilirubin (ALBI) grade is a simple objective model for assessing liver function in patients with HCC. An alternative to Child-Pugh without subjective components.

The UK model for end-stage liver disease, used by NHS Blood and Transplant to prioritise liver transplant listing. UKELD ≥49 is the threshold for transplant listing in the UK.

Defines eligibility for liver transplantation in patients with hepatocellular carcinoma (HCC). Patients within Milan criteria have 4-year recurrence-free survival >85%.

BMI, AST/ALT Ratio, and Diabetes (BARD) score predicts advanced fibrosis (F3-F4) in NAFLD. Score ≥2 has 96% negative predictive value for advanced fibrosis.

Histological scoring system for NAFLD severity on liver biopsy. Scores steatosis, lobular inflammation, and hepatocyte ballooning. NAS ≥5 is associated with NASH diagnosis.

Predicts survival after resection of colorectal cancer liver metastases. Five clinical risk factors predict recurrence and survival after hepatectomy.

Predicts safe discharge of adult patients presenting with acute lower GI bleeding. Score ≤8 associated with >95% probability of safe discharge.

Measures Crohn's disease activity over one week. The standard index for clinical trials. Remission: <150. Moderate-severe disease: 220–450. Severe: >450.

Simple clinical classification of ulcerative colitis severity. Identifies patients with severe colitis requiring hospitalisation and intensive treatment.

Endoscopic scoring system for ulcerative colitis severity. Validated for assessing mucosal disease activity during colonoscopy.

Endoscopic scoring of Crohn's disease activity across 5 ileocolonic segments. Correlates with CDAI and is used as an endpoint in clinical trials.

Predicts response to IV corticosteroids in acute severe ulcerative colitis (ASUC). The Oxford criteria identify patients who may need ciclosporin or urgent colectomy by day 3.

MANTRELS score for predicting acute appendicitis. Widely used in emergency settings to guide clinical decision-making and imaging requests.

Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score for acute appendicitis. Validated in Asian populations; more sensitive than Alvarado in this demographic.

Predicts risk of post-operative nausea and vomiting (PONV) to guide prophylactic antiemetic therapy. Each risk factor adds ~20% to baseline risk.

Classifies stool consistency into 7 types. Used clinically to assess bowel function, guide diagnosis of IBS, constipation, and diarrhoea, and monitor treatment response.

Tokyo Guidelines 2018 (TG18) for grading severity of acute cholangitis to guide management decisions including timing of biliary drainage.

Tokyo Guidelines 2018 (TG18) for grading severity of acute cholecystitis to guide timing of cholecystectomy.

Clinical criteria for the diagnosis of IBS based on symptom pattern. The original IBS diagnostic criteria, predating Rome. ≥3 of 6 criteria suggests IBS.

Endoscopic grading of reflux esophagitis based on mucosal break size and extent. Used to guide therapy and monitor GERD treatment response.

Simplified scoring system for diagnosis of autoimmune hepatitis (AIH). Score ≥7 = definite AIH; ≥6 = probable AIH. Easier to apply clinically than the original IAIHG score.

Differentiates osmotic from secretory diarrhoea. Osmotic gap >125 mOsm/kg suggests osmotic diarrhoea (stops with fasting). Gap <50 mOsm/kg suggests secretory diarrhoea (continues with fasting).

Cleveland Clinic Florida Wexner Score quantifies severity of faecal incontinence. Scores frequency of incontinence to gas, liquid, and solid stool, plus pad use and lifestyle alteration.

Non-invasive score to predict the presence of oesophageal varices (OV) in patients with chronic liver disease or cirrhosis, avoiding unnecessary endoscopy. Based on platelet count, spleen diameter, and albumin. Score below 3.90 has high negative predictive value (NPV) for ruling out varices needing treatment (VNT). From Marot et al. 2019.

Risk Estimation for Hepatocellular Carcinoma in Chronic Hepatitis B (REACH-B). Predicts 3-year, 5-year, and 10-year HCC risk in non-cirrhotic HBeAg-negative patients with chronic HBV. Based on sex, age, ALT, HBeAg status, and HBV DNA. Score 0-17. Developed by Yang et al. 2011 from the REVEAL-HBV cohort (n=3,584). NOT validated in cirrhotic patients.

Validated HCC diagnostic model combining Gender, Age, AFP-L3 (lens culinaris agglutinin-reactive fraction of AFP), AFP, and DCP (des-gamma-carboxyprothrombin; PIVKA-II). Developed by Johnson et al. 2014. Superior to AFP alone for early HCC detection. Validated across multiple aetiologies (HBV, HCV, ALD, NAFLD). GALAD score above -1.68 = HCC likely.

Validated risk score for clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreatoduodenectomy (Whipple procedure). Based on gland texture, pathology, pancreatic duct diameter, and intraoperative blood loss. Score 0-10; score 7-10 = high risk. From Callery et al. 2013 and modified Fistula Risk Score (a-FRS) by Mungroop et al. 2019.

Standardised endoscopic description of Barrett's oesophagus extent. C = circumferential extent (cm above GOJ); M = maximum extent (cm above GOJ). Used for surveillance interval determination and dysplasia reporting. BSG 2023 and NICE NG12 guidelines use Prague C&M to guide surveillance intervals. Short-segment Barrett's: maximum extent below 3 cm; long-segment: 3 cm or above.

Steatosis-Associated Fibrosis Estimator (SAFE) score. Non-invasive tool to identify patients with NAFLD/MASLD who have significant or advanced liver fibrosis (F2-F4) requiring further investigation or specialist referral. Combines simple laboratory tests. Developed by Newsome et al. 2022 as an improvement over FIB-4 alone for the NAFLD/MASLD population. Lower threshold has high sensitivity for ruling out fibrosis.

Validated clinical scoring system for the diagnosis of IBS in primary and secondary care. Uses symptom items and alarm feature exclusions. Originally described by Kruis et al. 1984. Positive score (above 44) has sensitivity ~75-78% and specificity ~85% for IBS diagnosis. Useful to differentiate IBS from organic GI disease. Has been largely superseded by Rome IV criteria but remains in clinical use.

CT-based severity scoring for acute pancreatitis. Combines Balthazar Grade (A-E, based on pancreatic/peripancreatic inflammation) and necrosis percentage. CTSI range 0-10. Score 7-10 = severe; associated with 17% complication rate and 17% mortality. Developed by Balthazar et al. 1990. Used alongside clinical scores (BISAP, APACHE II) for severity stratification.

The revised original scoring system from the International Autoimmune Hepatitis Group (IAIHG) for diagnosing autoimmune hepatitis (AIH). Unlike the simplified score (which is point-of-care), the revised original score uses detailed serological, histological, and treatment response data. Pre-treatment score above 15 = definite AIH; 10-15 = probable AIH. Developed by Alvarez et al. 1999.

Criteria to assess eligibility for liver transplantation in hepatocellular carcinoma (HCC). Milan Criteria (Mazzaferro 1996): single tumour up to 5 cm OR up to 3 tumours each up to 3 cm, no vascular invasion, no extrahepatic disease. UCSF Criteria (Yao 2001, expanded): single tumour up to 6.5 cm OR 2-3 tumours each up to 4.5 cm with total tumour diameter up to 8 cm. Note: milan_criteria_transplant already in file -- this provides comparison and clinical guidance.

Validated risk score predicting 90-day mortality following bariatric surgery. Five risk factors: BMI above 50, male sex, hypertension, known risk factors for pulmonary embolism, and age above 45 years. Score 0-5; class A (0-1) = low risk (0.31% mortality); class B (2-3) = intermediate (1.9%); class C (4-5) = high risk (7.56%). From DeMaria et al. 2007.

Validated VTE risk stratification tool for surgical patients. Each risk factor is weighted 1-5 points. Total score guides prophylaxis: very low risk (0) = early mobilisation only; low (1-2) = mechanical prophylaxis; moderate (3-4) = LMWH or mechanical; high (5 or above) = LMWH for extended duration. Originally validated by Caprini et al. 2005 in general and abdominal/pelvic surgery. Widely used in perioperative medicine.

Validated endoscopic scoring system for eosinophilic oesophagitis (EoE). Assesses 5 endoscopic features: Exudates, Rings, Oedema, Furrows, and Strictures. Score 0-9. Higher score = more active EoE. Used to monitor treatment response (dietary elimination, proton pump inhibitors, topical steroids, dupilumab). Developed by Hirano et al. 2013.

Rome IV criteria for functional dyspepsia (FD), the most common functional upper GI disorder. Encompasses two syndromes: Postprandial Distress Syndrome (PDS) and Epigastric Pain Syndrome (EPS). Bothersome meal-induced symptoms and/or epigastric pain/burning for at least 3 months with symptom onset at least 6 months before diagnosis. Must exclude organic disease (endoscopy, Helicobacter pylori testing). Affects 10-20% of adults in Western populations.

Standardised classification system for both Crohn's disease (CD) and ulcerative colitis (UC) based on age at diagnosis, disease location, and behaviour. Accepted international standard since 2005 Montreal IBD World Congress.

Rome IV criteria for diagnosing functional constipation in adults. Symptoms must have been present for >= 6 months with onset >= 6 months before diagnosis, and criteria met for the last 3 months.

Validated scoring system predicting operative difficulty and duration of laparoscopic cholecystectomy. Used for preoperative consent and surgical planning, particularly relevant for out-of-hours or high-risk scheduling decisions.

Non-invasive index for predicting fibrotic NASH (F2-F4 fibrosis) in patients with non-alcoholic fatty liver disease. Alternative to liver biopsy for identifying patients with advanced NAFLD needing specialist monitoring.

Second generation of the Metroticket criteria for predicting post-liver-transplant HCC recurrence. Incorporates AFP levels and sum of tumour diameters to allow expanded transplant criteria beyond Milan.

Clinical (pre-endoscopy) Rockall Score using only clinical variables available at admission, before endoscopy. Predicts mortality and re-bleeding in upper GI haemorrhage. The Glasgow-Blatchford score is more accurate for triage; pre-endoscopy Rockall identifies very high-risk patients.

Standard grading system for hepatic encephalopathy in cirrhotic patients, grading 0-4. Grade 0 (covert/minimal HE) through Grade 4 (coma). Essential for treatment decisions and prognosis.

Rome IV criteria for non-cardiac functional chest pain originating from the oesophagus. Requires cardiac aetiology to be excluded first. Diagnoses functional chest pain of presumed oesophageal origin.

Rome IV criteria for globus -- the persistent or intermittent non-painful sensation of a lump, foreign body, or tightness in the throat not associated with dysphagia or odynophagia. After excluding structural and reflux causes.

Rome IV criteria for Cyclic Vomiting Syndrome in adults. Stereotypical recurrent episodes of intense nausea and vomiting with intervening symptom-free periods. Associated with migraine spectrum disorders.

Rome IV criteria for diagnosing faecal incontinence in adults (age >= 4 years). The recurrent uncontrolled passage of faecal material in adults with developmentally appropriate toileting skills.

Comprehensive index combining histological (eosinophil count) and endoscopic (EREFS) features to assess disease severity in eosinophilic oesophagitis (EoE). Validated for monitoring treatment response.

CTCAE-based grading of immune-related colitis caused by checkpoint inhibitor immunotherapy (anti-PD-1, anti-PD-L1, anti-CTLA-4). Guides immunotherapy hold/discontinuation and corticosteroid management.

Clinical index predicting long-term steroid-free remission in patients with IBD treated with azathioprine or 6-mercaptopurine. Helps identify patients unlikely to respond to thiopurines who may benefit from early biologic therapy.

Predicts likelihood of acute appendicitis using clinical and laboratory findings. MANTRELS mnemonic: Migration, Anorexia, Nausea/Vomiting, Tenderness, Rebound, Elevated temperature, Leukocytosis, Shift.

Predicts outcome after hepatic resection for colorectal liver metastases. Five clinical risk factors identify patients most likely to benefit from resection.

Clinical criteria to support diagnosis of Irritable Bowel Syndrome (IBS). Positive predictive value increases with the number of criteria met. Predates Rome criteria.

Scoring system to diagnose Irritable Bowel Syndrome and distinguish it from organic bowel disease. Combines symptom scores with laboratory findings. Score >44 supports IBS diagnosis.

Simple clinical index for assessing Crohn disease activity. Simplified version of the Crohn Disease Activity Index (CDAI), not requiring a diary. Scores ≥5 indicate active disease.

Standardised endoscopic scoring system for eosinophilic oesophagitis (EoE). Assesses 5 endoscopic features to grade severity and monitor treatment response.

Predicts the presence of oesophageal varices needing treatment (VNT) in patients with compensated cirrhosis. Helps identify patients who can safely avoid endoscopic screening.

MELD 3.0 — updated MELD incorporating sex-specific factor and albumin. Improves survival prediction in women and those with low albumin. Replaces MELD-Na for organ allocation in some centres.

MELD-Na (UNOS/OPTN) incorporates serum sodium into the standard MELD score. Currently used by UNOS for liver transplant organ allocation in the United States. Improves prediction over MELD alone.

GALAD biomarker model for early detection of hepatocellular carcinoma (HCC) in patients with cirrhosis or chronic hepatitis. Combines sex, age, AFP-L3, AFP, and DCP (PIVKA-II).

King's College Hospital criteria for liver transplantation in paracetamol-induced acute liver failure. Identifies patients unlikely to survive without transplantation.

CTCAE v5.0 grading of immune-related adverse event (irAE) hepatitis from checkpoint inhibitor immunotherapy. Guides management decisions including corticosteroid dosing and immunotherapy interruption.

Predicts need for clinical intervention (transfusion, endoscopy, surgery) in acute upper GI bleeding. Score of 0 identifies low-risk patients suitable for outpatient management.

Simplified Apfel score predicts risk of postoperative nausea and vomiting (PONV). Four independent risk factors guide prophylactic antiemetic prescription.

Assesses severity of chronic liver disease and predicts surgical mortality and prognosis. Classifies into Child-Pugh A, B, or C.

Differentiates portal hypertension from non-portal hypertension causes of ascites. SAAG >=11 g/L suggests portal hypertension.

Grades severity of hepatic encephalopathy (HE) using the West Haven Criteria (Conn criteria). Guides treatment intensity and monitoring.

Predicts need for clinical intervention in upper GI bleeding. Score 0 = very low risk; can be discharged safely without endoscopy.

Risk stratification for obscure gastrointestinal bleeding (OGIB) — bleeding of unknown origin after upper and lower endoscopy. Guides capsule endoscopy timing.

Non-invasive scoring to identify advanced fibrosis (F3-F4) in NAFLD/MASLD patients. Avoids need for liver biopsy in many patients.

Classifies severity of acute cholangitis using the 2018 Tokyo Guidelines (TG18) to guide timing of biliary drainage and antibiotic therapy.