Model for end-stage liver disease, model for end-stage liver disease-sodium and Child–Turcotte–Pugh scores over time for the prediction of complications of liver cirrhosis
Article first published online: 9 JUN 2008
© 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Ltd
Volume 29, Issue 2, pages 221–226, February 2009
How to Cite
Choi, P. C., Kim, H. J., Choi, W. H., Park, D. I., Park, J. H., Cho, Y. K., Sohn, C. I., Jeon, W. K. and Kim, B. I. (2009), Model for end-stage liver disease, model for end-stage liver disease-sodium and Child–Turcotte–Pugh scores over time for the prediction of complications of liver cirrhosis. Liver International, 29: 221–226. doi: 10.1111/j.1478-3231.2008.01803.x
- Issue published online: 6 JAN 2009
- Article first published online: 9 JUN 2008
- Received 25 February 2008Accepted 5 May 2008
- hepatic encephalopathy;
- model for end stage liver disease (MELD);
- variceal bleeding
Background/Aims: There has been no report concerning the predictive capability of each scoring system in determining the development of complications of liver cirrhosis such as variceal bleeding and/or hepatic encephalopathy.
Methods: We retrospectively studied 128 patients with liver cirrhosis [92 males; mean (standard deviation) 54.2 (11.2) years] admitted to our institution from March 2004 to April 2006. Seventy-three patients (57.0%, group 1) were admitted because of complications of cirrhosis and 55 patients (43.0%, group 2) were admitted for causes unrelated to complications of cirrhosis. We calculated values for model for end-stage liver disease (MELD), MELD-sodium (MELD-Na) and Child–Turcotte–Pugh (CTP) scores on admission and at 3 and 6 months before admission. Each delta score was defined as the difference in the scores of 3 and 6 months before admission.
Results: The relative risk for complications in the patients with ΔMELD/3 months ≥1.35, ΔMELD-Na/3 months ≥1.35 and ΔCTP/3 months ≥1 was 2.05 [95% confidence intervals (CI) 1.47–2.85, P<0.01], 2.04 (95% CI 1.45–2.88, P<0.01) and 1.98 (95% CI 1.39–2.81, P<0.01) respectively. The area under the receiver-operating characteristic curves of ΔMELD/3 months, ΔMELD-Na/3 months and ΔCTP/3 months for the occurrence of cirrhotic complications were 0.691, 0.694 and 0.722 respectively. A higher ΔMELD/3 months (≥1.35), ΔMELD-Na/3 months (≥1.35) and ΔCTP/3 months (≥1) was associated with decreased survival.
Conclusions: Delta model for end-stage liver disease/3 months, ΔMELD-Na/3 months and ΔCTP/3 months were clinically useful parameters for predicting the occurrence of cirrhotic complications.