Comparison of the Model for End-stage Liver Disease and hepatic venous pressure gradient for predicting survival in patients with decompensated liver cirrhosis.
10.3350/kjhep.2009.15.3.350
- Author:
Sung Hoa LEE
1
;
Seung Ha PARK
;
Go Woon KIM
;
Woo Jin LEE
;
Won Ki HONG
;
Myeong Shin RYU
;
Kyu Tae PARK
;
Min Young LEE
;
Chan Woo LEE
;
Jin Ho KIM
;
Yong Mook KIM
;
Sung Jung KIM
;
Gwang Ho BAIK
;
Jin Bong KIM
;
Dong Joon KIM
Author Information
1. Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea. djkim@hallym.ac.kr
- Publication Type:Original Article ; Comparative Study ; English Abstract
- Keywords:
Decompensated;
Cirrhosis;
Model for End-stage Liver Disease;
Hepatic Venous Pressure Gradient;
Prognosis
- MeSH:
Adult;
Aged;
Area Under Curve;
Cohort Studies;
Female;
Hepatic Veins/*physiopathology;
Humans;
Liver Cirrhosis/diagnosis/*mortality/physiopathology;
Liver Failure/diagnosis/*mortality/physiopathology;
Male;
Middle Aged;
Models, Biological;
Predictive Value of Tests;
Prognosis;
Proportional Hazards Models;
Regression Analysis;
Retrospective Studies;
Severity of Illness Index;
Survival Analysis;
Venous Pressure
- From:The Korean Journal of Hepatology
2009;15(3):350-356
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: This study compared the prognostic values of the Model for End-stage Liver Disease (MELD) and the hepatic venous pressure gradient (HVPG) in the prediction of death within 3 and 12 months in patients with decompensated liver cirrhosis. METHODS: We used data from 136 consecutive patients with decompensated cirrhosis who underwent HVPG between January 2006 and June 2008. Cox regression analysis was used to investigate the independent relationships with death of MELD and HVPG. The prognostic accuracies of MELD and HVPG were analyzed by calculating the area under the receiver operating characteristic curve (AUROC) for the occurrence of death within 3 and 12 months. RESULTS: Both MELD and HVPG were independent predictors of death [hazard ratio (HR)=1.11 and 1.12, respectively; 95% confidence interval (CI)=1.04~1.20 and 1.08-1.16]. Analysis of the AUROC demonstrated that the prognostic power did not differ between MELD and HVPG for predicting the 3-month survival (HR=0.76 and 0.68, respectively; 95% CI=0.62~0.89 and 0.52~0.84; P=0.22) or the 12-month survival (HR=0.72 and 0.73, 95% CI=0.61~0.83 and CI=0.61~0.84). CONCLUSIONS: Both MELD and HVPG are independent prognostic factors of death within 3 and 12 months in patients with decompensated liver cirrhosis, and their accuracies are similar. However, HVPG has a limited role in the prediction of death in decompensated cirrhosis due to its invasiveness and limited use.
