Predictive value of the initial MELD score and its derivative scores for early survival rate after liver transplantation in patients with liver failure
10.3969/j.issn.1674-7445.2022.04.012
- VernacularTitle:术后首次MELD评分及其衍生评分对肝衰竭患者肝移植术后早期生存率的预测价值
- Author:
Man LAI
1
;
Xin WANG
;
Qinwei YAO
;
Haixia LIU
;
Ying XU
;
Li HE
;
Guangming LI
Author Information
1. Department of Critical Care Medicine, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
- Publication Type:Research Article
- Keywords:
Liver failure;
Liver transplantation;
Model for end-stage liver disease (MELD) score;
Model for end-stage liver disease combined with serum sodium (MELD-Na) score;
Model for end-stage liver disease combined with serum lactic acid (MELD-Lac) score;
Receiver operating characteristic (ROC) curve;
Early prognosis;
Predictive value
- From:
Organ Transplantation
2022;13(4):489-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the predictive values of the initial model for end-stage liver disease (MELD) score, MELD combined with serum sodium (MELD-Na) score and MELD combined with serum lactic acid (MELD-Lac) score for early survival rate after liver transplantation in patients with liver failure. Methods Clinical data of 135 recipients undergoing liver transplantation for liver failure were retrospectively analyzed. All patients were divided into the early survival group (n=110) and early death group (n=25) according to the survival at postoperative 28 d. Clinical data were compared between two groups. The optimal cut-off values of MELD, MELD-Na and MELD-Lac scores for predicting early survival rate after liver transplantation in patients with liver failure were determined by the receiver operating characteristic (ROC) curve. The predictive values of different scores for early survival rate after liver transplantation in patients with liver failure were evaluated. Results Significant differences were observed in the initial MELD, MELD-Na and MELD-Lac scores after liver transplantation between two groups (all P < 0.05). For the initial MELD, MELD-Na and MELD-Lac scores in predicting early survival rate after liver transplantation in patients with liver failure, the AUC were 0.653 [95% confidence interval (CI) 0.515-0.792], 0.648 (95%CI 0.514-0.781) and 0.809 (95%CI 0.718-0.900), the optimal cut-off values were 18.09, 18.09 and 19.97, Youden's indexes were 0.398, 0.380 and 0.525, the sensitivity was 0.680, 0.680 and 0.840, and the specificity was 0.720, 0.700 and 0.690, respectively. The AUC of MELD-Lac score was higher than those of MELD and MELD-Na scores, and the differences were statistically significant (both P < 0.05). Conclusions Compared with the initial MELD and MELD-Na scores after liver transplantation, the initial MELD-Lac score is a more reliable index for predicting early survival rate after liver transplantation in patients with liver failure.
