End-Stage Liver Disease Model in the Evaluation of Artificial Liver Treatment for Chronic Liver Failure
10.3969/j.issn.0253-9896.2014.05.018
- VernacularTitle:终末期肝病评分模型在评价慢性肝衰竭人工肝治疗效果中的应用
- Author:
Liwen SONG
;
Qian LI
;
Huan LIU
;
Fei LI
;
Wukui CAO
;
Jiming YANG
- Publication Type:Journal Article
- Keywords:
liver failure;
liver,artificial;
evaluation studies;
prognosis;
model of end-stage liver disease;
MELD-Na model;
iMELD model
- From:
Tianjin Medical Journal
2014;(5):466-469
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of model for end-stage liver disease (MELD) score, MELD with in-corporation of serum sodium (MELD-Na) score and integrated MELD (iMELD) score for evaluation of prognosis of chronic liver failure. Methods A total of 159 consecutive patients with chronic liver failure were included in the study and divided into two groups (death group and survival group) according to the prognosis. The levels of total bilirubin (TBIL), serum creati-nine (Cr), prothrombin time (PT), PT international normalized ratio (INR), serum sodium (Na+), age, MELD, MELD-Na and iMELD were calculated respectively and the comparative analysis was performed. Areas under the receiver operating charac-teristic curve (AUC-ROC) of MELD, MELD-Na and iMELD were used to assess the prognosis in patients with chronic liver failure. Results The values of TBIL (μmol/L:330.9±181.9 vs 245.5±127.7),Cr (μmol/L:84.9±63.8 vs 81.2±49.3),INR (2.50±1.01 vs 2.09±0.57),MELD (26.2±6.5 vs 22.0±5.8),MELD-Na (35.9±31.5 vs 25.3±8.7) and iMELD (49.5±17.4 vs 42.4±10.9) were significantly higher in death group than those in survival group (P < 0.01). The serum level of Na+ was signif- icantly lower in death group than that of survival group (P < 0.01). The mortality of liver failure was higher in patients with the increased scores of MELD, MELD-Na and iMELD. The area under curve (AUC) values generated by the ROC curves was no difference respectively (P > 0.05) for MELD score (AUC=0.691), MELD-Na score (AUC=0.690) and iMELD score (AUC= 0.674) . The cut-off scores of three systems were 25.8 (MELD), 31.0 (MELD-Na) and 53.5 (iMELD) respectively, which could discriminate higher and lower mortality accurately. Conclusion MELD, MELD-Na and iMELD scores can predict short-term clinical outcomes of liver failure patients undergoing artificial liver comprehensive medical treatment.
