期刊
JOURNAL OF CLINICAL GASTROENTEROLOGY
卷 43, 期 6, 页码 580-585出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCG.0b013e3181889468
关键词
cirrhosis; prognostic; mortality; Child-Pugh score; MELD
Background/Goals: Superiority of the model for end-stage liver disease (MELD) over the Child-Pugh score for the prediction of Outcome in patients with chronic liver disease is still debated. The main objective of this prospective Study was to evaluate the accuracy of the Child-Pugh score, the MELD, and the new score, MELD-Na, combining MELD and serum sodium (Na), for the prediction of 6-month mortality in cirrhotic patients. Study: In all, 308 consecutive cirrhotic patients were included. Child-Pugh score, MELD, and MELD-Na were calculated at the inclusion. Results: In all, 154 patients (50.0%) had decompensated cirrhosis. Forty-five patients died during the 6-month follow-up: 3 in the subgroup of compensated cirrhosis and 42 in the decompensated subgroup (1.9% vs. 27.3%, P < 10(-3)). Area under the receiver operating characteristic curve for the prediction of 6-month mortality of Child-Pugh score, MELD, and MELD-Na were. respectively, in the whole population: 0.882, 0.866, and 0.887 (P = NS), and in the subgroup of decompensated cirrhosis: 0.796, 0.800, and 0.833 (P = NS). MELD-Na had the highest accuracy but the difference reached statistical significance only with the Child-Pugh score in the subgroup of patients with decompensated cirrhosis (79.9% vs. 68.0%, P = 0.006). The combination of Child-Pugh score or MELD with other variables reflecting the circulatory dysfunction observed in end-stage liver disease significantly improved the accuracy of these 2 models. Conclusions: Child-Pugh score remains a simple and effective tool for the prognostic assessment of cirrhotic patients at bedside and can still be used in clinical practice. MELD, and especially MELD-Na, should be reserved for patients with decompensated cirrhosis.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据