Model for end-stage liver disease score to serum sodium ratio index as a prognostic predictor and its correlation with portal pressure in patients with liver cirrhosis

  1. Teh-Ia Huo1,3,†,
  2. Ying-Wen Wang2,3,†,
  3. Ying-Ying Yang2,3,
  4. Han-Chieh Lin2,3,
  5. Pui-Ching Lee3,
  6. Ming-Chih Hou2,3,
  7. Fa-Yauh Lee2,3,
  8. Shou-Dong Lee2,3

Article first published online: 16 FEB 2007

DOI: 10.1111/j.1478-3231.2007.01445.x

Issue

Liver International

Liver International

Volume 27, Issue 4, pages 498–506, May 2007

Additional Information

How to Cite

Huo, T.-I., Wang, Y.-W., Yang, Y.-Y., Lin, H.-C., Lee, P.-C., Hou, M.-C., Lee, F.-Y. and Lee, S.-D. (2007), Model for end-stage liver disease score to serum sodium ratio index as a prognostic predictor and its correlation with portal pressure in patients with liver cirrhosis. Liver International, 27: 498–506. doi: 10.1111/j.1478-3231.2007.01445.x

Author Information

  1. 1

    Institute of Pharmacology, National Yang-Ming University School of Medicine, Taipei, Taiwan

  2. 2

    Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan

  3. 3

    Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

  1. †

    *Contributed equally to this work.

*Correspondence Han-Chieh Lin, MD, Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan. Fax: +886 2 2873 9318 e-mail: hclin@vghtpe.gov.tw

  1. †

    *Contributed equally to this work.

Publication History

  1. Issue published online: 16 FEB 2007
  2. Article first published online: 16 FEB 2007
  3. Received 14 November 2006accepted 27 December 2006

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Keywords:

  • liver cirrhosis;
  • MELD;
  • MESO index;
  • portal pressure;
  • serum sodium

Abstract

Background: The models for end-stage liver disease (MELD) and serum sodium (SNa) are important prognostic markers in cirrhosis. A novel index, MELD to SNa ratio (MESO), was developed to amplify the opposing effect of MELD and SNa on outcome prediction.

Methods: A total of 213 cirrhotic patients undergoing hepatic venous pressure gradient (HVPG) measurement were retrospectively analyzed.

Results: The MESO index correlated with HVPG (r=0.258, P<0.001) and Child–Pugh score (ρ=0.749, P<0.001). Using mortality as the end point, the area under receiver operating characteristic curve (AUC) was 0.860 for SNa, 0.795 for the MESO index and 0.789 for MELD (P values all >0.3) at 3 months. Among patients with Child–Pugh class A or B, the MESO index had a significantly higher AUC compared with MELD (0.80 vs. 0.766, P<0.001). A MESO index <1.6 identified 97% of patients who survived at 3 months and the predicted survival rate was 96.5%. In survival analysis, MESO index >1.6 independently predicted a higher mortality rate (relative risk: 3.32, P<0001) using the Cox model.

Conclusions: The MESO index, which takes into account the predictive power of both MELD and SNa, is a useful prognostic predictor for both short- and long-term survival in cirrhotic patients.

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