*Contributed equally to this work.
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
Version of Record online: 16 FEB 2007
Volume 27, Issue 4, pages 498–506, May 2007
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
- Issue online: 16 FEB 2007
- Version of Record online: 16 FEB 2007
- Received 14 November 2006accepted 27 December 2006
- liver cirrhosis;
- MESO index;
- portal pressure;
- serum sodium
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.