Respective analysis of dead patients with cirrhosis by Child-Pugh score and model of end-stage liver disease score.
10.3969/j.issn.1672-7347.2012.10.009
- Author:
Jie ZHANG
1
;
Fanggen LU
;
Chunhui OUYANG
;
Zongyong CHENG
;
Xuehong WANG
;
Xiaowei LIU
Author Information
1. Department of Gastroenterology, Central South University, Changsha, China.
- Publication Type:Journal Article
- MeSH:
End Stage Liver Disease;
diagnosis;
mortality;
Esophageal and Gastric Varices;
Humans;
Liver Cirrhosis;
diagnosis;
mortality;
Prognosis;
ROC Curve;
Retrospective Studies;
Risk Factors;
Severity of Illness Index
- From:
Journal of Central South University(Medical Sciences)
2012;37(10):1021-1025
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To understand the value of Child-Pugh (CP) classification and model of end-stage liver disease (MELD) score for patients with cirrhosis and their prognosis by retrospectively analyzing the two methods in hemorrhage death and non-hemorrhage death in patients with liver cirrhosis.
METHODS:A total of 72 patients who died of cirrhosis (the death group) were analyzed retrospectively, and the initial data in the hospital before death were collected. The initial information of the control group (88 patients) at the same time was also obtained. The death group was divided into two subgroups: esophagus varicosity burst massive hemorrhage death group and non-hemorrhage death group.
RESULTS:MELD score and CP score of the death group (22.230±13.451, 10.264±2.028) were significantly higher than those of the control group (15.370±6.201, 9.318±1.644; P<0.05). The MELD score and CP score for the massive bleeding death group were close to those of the control group. There was significant difference between the non-hemorrhage death group and the control group. The ratio of patients with CP grade A and MELD scores<20 died for massive bleeding in the death group was more than 70%, and that of CP grade C and MELD scores ≥ 30 in the death group was higher. ROC surve analysis found the accuracy of short-term predication of survival by MELD score and CP classification was improved after eliminating the risk factors of hemorrage.
CONCLUSION:MELD and CP play a role in evaluating the state and prognosis of patients with cirrhosis. MELD score and CP classification predict the short-term survival efficiently on the premise of excluding the risk factors of esophagus and/or stomach bottom varicosity burst massive bleeding. CP and MELD scores are deficiencies, especially for low MELD score (<20) and CP level A patients. The prognostic accuracy may be improved when combining esophageal gastric fundal varices.
