Abstract
Natural history of cirrhosis has two well defined phases: compensated and decompensated cirrhosis. Importantly, the prognosis is clearly different. While survival in compensated patients is similar to the observed in general population, decompensated patients have a worse prognosis. However, a validated prognostic tool to properly establish prognosis in cirrhosis is not available. The aim during the compensated phase of disease should be to estimate the risk of having decompensation while the prediction of death is mandatory in patients with decompensated cirrhosis. Furthermore, it is necessary the development of robust prognostic models for each phase of the disease that should probably incorporate different variables for each moment. Regarding serum parameters, it is important to discriminate among those aimed to establish the existence of liver disease (i.e. ALT or alkaline phosphatase) from those aimed to evaluate liver synthetic function (i.e. bilirubin, albumin or INR)
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