Predicting Mortality and Cirrhosis-Related Complications with MELD3.0: A Multicenter Cohort Analysis
- Author:
Jihye LIM
1
;
Ji Hoon KIM
;
Ahlim LEE
;
Ji Won HAN
;
Soon Kyu LEE
;
Hyun YANG
;
Heechul NAM
;
Hae Lim LEE
;
Do Seon SONG
;
Sung Won LEE
;
Hee Yeon KIM
;
Jung Hyun KWON
;
Chang Wook KIM
;
U Im CHANG
;
Soon Woo NAM
;
Seok-Hwan KIM
;
Pil Soo SUNG
;
Jeong Won JANG
;
Si Hyun BAE
;
Jong Young CHOI
;
Seung Kew YOON
;
Myeong Jun SONG
Author Information
- Publication Type:Original Article
- From:Gut and Liver 2025;19(3):427-437
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score.
Methods:We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score.
Results:A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites.
Conclusions:The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.
