Comparison of five scoring systems for predicting the prognosis of patients with chronic severe hepatitis
10.3760/cma.j.issn.1000-6680.2010.07.009
- VernacularTitle:五种评分系统对慢性重型肝炎预后的预测价值比较及其临床意义
- Author:
Chao YE
;
Yongping CHEN
;
Xiaozhi JIN
;
Minghua ZHENG
;
Wenyuan LI
;
Erhui XIAO
;
Yuan CHENG
- Publication Type:Journal Article
- Keywords:
Hepatitis,viral,human;
Risk assessment;
ROC curve;
Prognosis
- From:
Chinese Journal of Infectious Diseases
2010;28(7):418-421
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the roles of five scoring systems including model for endstage liver disease (MELD), Child-Turcotte-Pugh (CTP), Mayo, MESO and MELD-Na scoring systems, in predicting the prognosis of patients with chronic severe hepatitis. Methods The clinical data of 213 patients with chronic severe hepatitis were retrospectively studied. The five scoring systems were applied respectively to evaluate the scores in survival group and death group. The capability of these five scoring systems to predict the prognosis of severe hepatitis were compared by the receiver operating characteristic (ROC) curve, area under curve (AUC) and cut-off value.Measurement data were compared by group t test. The comparisons of AUC among scoring systems were done using MEDCLAC software. Results The scores of death group evaluated by MELD, CTP,Mayo, MESO or MELD-Na scoring systems (30.6 ± 9.5, 11.3 ± 1.5, 10.4 ± 1.3, 2.3 ± 0.8 and 39.0 ± 11.8, respectively) were consistently higher than those of survival group (21.1± 6.8, 10.6 ±1.6, 9.0±1.5, 1.6±0.5 and 22.6±8.2, respectively) (P＜0.01). The values of AUC of these five systems were 0.810, 0.623, 0.749, 0.829 and 0.885, respectively. The Youden's indexes of these five systems were 0.507, 0.175, 0.389, 0.528 and 0.650, respectively. Conclusions The CTP scoring systems can not predict the prognosis of chronic severe hepatitis very well. The Mayo scoring systems can partially predict the prognosis. On the contrary, MELD, MESO and MELD-Na systems can successfully predict the disease prognosis, and the score of MELD-Na system shows the best correlation with the prognosis.
