Comparison study of five scoring systems for evaluating prognosis of patients undergoing transjugular intrahepatic portosystemic shunt procedures.
- VernacularTitle:五种评分系统对经颈静脉肝内门体静脉分流术患者预后的评价比较
- Author:
Longyue WEN
1
;
Song HE
;
Hao ZHANG
;
Xiaoping LUO
Author Information
- Publication Type:Journal Article
- MeSH: End Stage Liver Disease; Humans; Liver Cirrhosis; Portasystemic Shunt, Transjugular Intrahepatic; Prognosis; ROC Curve; Severity of Illness Index; Sodium; Survival Rate
- From: Chinese Journal of Hepatology 2014;22(7):514-518
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo compare the model for end-stage liver disease (MELD), delta model for end-stage liver disease (deltaMELD), MELD and serum sodium (MELD-Na), MELD score to serum sodium ratio index (MESO), and integrated end-stage liver disease model (iMELD) scoring systems for their utility in evaluating medium-short term prognosis of cirrhotic patients who underwent the transjugular intrahepatic portosystemic shunt (TIPS) procedure.
METHODSA total of 101 patients with liver cirrhosis who underwent the TIPS procedure between January 2011 and May 2013 were enrolled and followed-up for 1, 3 and 6 months.The MELD, deltaMELD, MELD-Na, MESO, and iMELD scores were assessed for each patient, according to the clinical data.The accuracy of the five scoring systems for predicting prognosis was analyzed and compared by the area under the receiver operating characteristic (ROC) curve.
RESULTSScores according to the different systems, which were recorded up to the patients' follow-up cut-off times (without death) were:MELD:19.35 +/- 5.78, deltaMELD:2.47 +/- 1.38, MELD-Na:18.23 +/- 7.82, MESO:1.57 +/- 0.43, and iMELD:33.76 +/- 9.58).For the patients who died, the scores were:MELD:24.36 +/- 5.67, deltaMELD:4.35 +/- 1.61, MELDNa:28.54 +/- 8.06, MESO:2.16 +/- 0.59, and iMELD:48.05 +/- 12.64.The differences between these five scores in the death group showed statistical significance (all P less than 0.01).As the scores of MELD, deltaMELD, MELDNa, MESO and iMELD increased, the survival rate of the patients decreased correspondingly.The differences between the survival rate and survival curve of each group showed statistical significance (P less than 0.01).The area under the curve was 0.735 for MELD, 0.769 for deltaMELD, 0.803 for MELD-Na, 0.740 for MESO and 0.816 for iMELD, and the differences did not show statistical significance (P more than 0.05).
CONCLUSIONThe MELD and MELD-based scoring systems (deltaMELD, MELD-Na, MESO and iMELD), can all predict medium-short term prognosis well.These five scoring systems showed no statistically significant difference in their predictive value.
