1.Predicting Mortality and Cirrhosis-Related Complications with MELD3.0: A Multicenter Cohort Analysis
Jihye LIM ; Ji Hoon KIM ; Ahlim LEE ; Ji Won HAN ; Soon Kyu LEE ; Hyun YANG ; Heechul NAM ; Hae Lim LEE ; Do Seon SONG ; Sung Won LEE ; Hee Yeon KIM ; Jung Hyun KWON ; Chang Wook KIM ; U Im CHANG ; Soon Woo NAM ; Seok-Hwan KIM ; Pil Soo SUNG ; Jeong Won JANG ; Si Hyun BAE ; Jong Young CHOI ; Seung Kew YOON ; Myeong Jun SONG
Gut and Liver 2025;19(3):427-437
Background/Aims:
This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score.
Methods:
We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score.
Results:
A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites.
Conclusions
The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.
2.Predicting Mortality and Cirrhosis-Related Complications with MELD3.0: A Multicenter Cohort Analysis
Jihye LIM ; Ji Hoon KIM ; Ahlim LEE ; Ji Won HAN ; Soon Kyu LEE ; Hyun YANG ; Heechul NAM ; Hae Lim LEE ; Do Seon SONG ; Sung Won LEE ; Hee Yeon KIM ; Jung Hyun KWON ; Chang Wook KIM ; U Im CHANG ; Soon Woo NAM ; Seok-Hwan KIM ; Pil Soo SUNG ; Jeong Won JANG ; Si Hyun BAE ; Jong Young CHOI ; Seung Kew YOON ; Myeong Jun SONG
Gut and Liver 2025;19(3):427-437
Background/Aims:
This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score.
Methods:
We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score.
Results:
A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites.
Conclusions
The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.
3.Predicting Mortality and Cirrhosis-Related Complications with MELD3.0: A Multicenter Cohort Analysis
Jihye LIM ; Ji Hoon KIM ; Ahlim LEE ; Ji Won HAN ; Soon Kyu LEE ; Hyun YANG ; Heechul NAM ; Hae Lim LEE ; Do Seon SONG ; Sung Won LEE ; Hee Yeon KIM ; Jung Hyun KWON ; Chang Wook KIM ; U Im CHANG ; Soon Woo NAM ; Seok-Hwan KIM ; Pil Soo SUNG ; Jeong Won JANG ; Si Hyun BAE ; Jong Young CHOI ; Seung Kew YOON ; Myeong Jun SONG
Gut and Liver 2025;19(3):427-437
Background/Aims:
This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score.
Methods:
We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score.
Results:
A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites.
Conclusions
The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.
4.Predicting Mortality and Cirrhosis-Related Complications with MELD3.0: A Multicenter Cohort Analysis
Jihye LIM ; Ji Hoon KIM ; Ahlim LEE ; Ji Won HAN ; Soon Kyu LEE ; Hyun YANG ; Heechul NAM ; Hae Lim LEE ; Do Seon SONG ; Sung Won LEE ; Hee Yeon KIM ; Jung Hyun KWON ; Chang Wook KIM ; U Im CHANG ; Soon Woo NAM ; Seok-Hwan KIM ; Pil Soo SUNG ; Jeong Won JANG ; Si Hyun BAE ; Jong Young CHOI ; Seung Kew YOON ; Myeong Jun SONG
Gut and Liver 2025;19(3):427-437
Background/Aims:
This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score.
Methods:
We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score.
Results:
A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites.
Conclusions
The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.
5.Association Between Psychotic Symptoms of Mood Disorders and Hematologic Findings Related to Inflammation: A Retrospective Study
Yoon-Seok OH ; Woo-Young IM ; Sang-Ho SHIN ; Jae-Chang LEE ; Ji-Woong KIM ; Seung-Jun KIM ; Na-Hyun LEE ; Hong-Seok OH
Korean Journal of Psychosomatic Medicine 2024;32(2):77-86
Objectives:
:This study was aimed to determine whether the presence or absence of psychotic symptoms inmood disorders is statistically significantly related to the difference between NLR, MLR, PLR.
Methods:
:We retrospectively reviewed the medical records of 408 patients who were hospitalized with a diagnosis of bipolar disorder type 1 (BP-I) and major depressive disorder (MDD) and underwent complete blood count.Groups were divided based on the presence or absence of psychotic symptoms. The statistical significance of the differences in NLR, MLR, and PLR between each group was examined using t-test.
Results:
:When 382 mood disorder patients were divided into groups based solely on the presence or absence ofpsychotic symptoms, the difference between NLR and MLR was statistically significant (NLR: p=0.009, MLR:p=0.016). When dividing the mood disorder patients into subgroups of 176 BP-I patients and 206 MDD patients and using the same method for each subgroup, the tendency for higher NLR and MLR was maintained, but the sta-tistical significance disappeared.
Conclusions
:This study suggests the possibility of relationship between psychotic symptoms and NLR and MLR in mood disorders, but additional research appears to be necessary to clarify the possibility.
6.Association Between Psychotic Symptoms of Mood Disorders and Hematologic Findings Related to Inflammation: A Retrospective Study
Yoon-Seok OH ; Woo-Young IM ; Sang-Ho SHIN ; Jae-Chang LEE ; Ji-Woong KIM ; Seung-Jun KIM ; Na-Hyun LEE ; Hong-Seok OH
Korean Journal of Psychosomatic Medicine 2024;32(2):77-86
Objectives:
:This study was aimed to determine whether the presence or absence of psychotic symptoms inmood disorders is statistically significantly related to the difference between NLR, MLR, PLR.
Methods:
:We retrospectively reviewed the medical records of 408 patients who were hospitalized with a diagnosis of bipolar disorder type 1 (BP-I) and major depressive disorder (MDD) and underwent complete blood count.Groups were divided based on the presence or absence of psychotic symptoms. The statistical significance of the differences in NLR, MLR, and PLR between each group was examined using t-test.
Results:
:When 382 mood disorder patients were divided into groups based solely on the presence or absence ofpsychotic symptoms, the difference between NLR and MLR was statistically significant (NLR: p=0.009, MLR:p=0.016). When dividing the mood disorder patients into subgroups of 176 BP-I patients and 206 MDD patients and using the same method for each subgroup, the tendency for higher NLR and MLR was maintained, but the sta-tistical significance disappeared.
Conclusions
:This study suggests the possibility of relationship between psychotic symptoms and NLR and MLR in mood disorders, but additional research appears to be necessary to clarify the possibility.
7.Association Between Psychotic Symptoms of Mood Disorders and Hematologic Findings Related to Inflammation: A Retrospective Study
Yoon-Seok OH ; Woo-Young IM ; Sang-Ho SHIN ; Jae-Chang LEE ; Ji-Woong KIM ; Seung-Jun KIM ; Na-Hyun LEE ; Hong-Seok OH
Korean Journal of Psychosomatic Medicine 2024;32(2):77-86
Objectives:
:This study was aimed to determine whether the presence or absence of psychotic symptoms inmood disorders is statistically significantly related to the difference between NLR, MLR, PLR.
Methods:
:We retrospectively reviewed the medical records of 408 patients who were hospitalized with a diagnosis of bipolar disorder type 1 (BP-I) and major depressive disorder (MDD) and underwent complete blood count.Groups were divided based on the presence or absence of psychotic symptoms. The statistical significance of the differences in NLR, MLR, and PLR between each group was examined using t-test.
Results:
:When 382 mood disorder patients were divided into groups based solely on the presence or absence ofpsychotic symptoms, the difference between NLR and MLR was statistically significant (NLR: p=0.009, MLR:p=0.016). When dividing the mood disorder patients into subgroups of 176 BP-I patients and 206 MDD patients and using the same method for each subgroup, the tendency for higher NLR and MLR was maintained, but the sta-tistical significance disappeared.
Conclusions
:This study suggests the possibility of relationship between psychotic symptoms and NLR and MLR in mood disorders, but additional research appears to be necessary to clarify the possibility.
8.Association Between Psychotic Symptoms of Mood Disorders and Hematologic Findings Related to Inflammation: A Retrospective Study
Yoon-Seok OH ; Woo-Young IM ; Sang-Ho SHIN ; Jae-Chang LEE ; Ji-Woong KIM ; Seung-Jun KIM ; Na-Hyun LEE ; Hong-Seok OH
Korean Journal of Psychosomatic Medicine 2024;32(2):77-86
Objectives:
:This study was aimed to determine whether the presence or absence of psychotic symptoms inmood disorders is statistically significantly related to the difference between NLR, MLR, PLR.
Methods:
:We retrospectively reviewed the medical records of 408 patients who were hospitalized with a diagnosis of bipolar disorder type 1 (BP-I) and major depressive disorder (MDD) and underwent complete blood count.Groups were divided based on the presence or absence of psychotic symptoms. The statistical significance of the differences in NLR, MLR, and PLR between each group was examined using t-test.
Results:
:When 382 mood disorder patients were divided into groups based solely on the presence or absence ofpsychotic symptoms, the difference between NLR and MLR was statistically significant (NLR: p=0.009, MLR:p=0.016). When dividing the mood disorder patients into subgroups of 176 BP-I patients and 206 MDD patients and using the same method for each subgroup, the tendency for higher NLR and MLR was maintained, but the sta-tistical significance disappeared.
Conclusions
:This study suggests the possibility of relationship between psychotic symptoms and NLR and MLR in mood disorders, but additional research appears to be necessary to clarify the possibility.
9.Association Between Psychotic Symptoms of Mood Disorders and Hematologic Findings Related to Inflammation: A Retrospective Study
Yoon-Seok OH ; Woo-Young IM ; Sang-Ho SHIN ; Jae-Chang LEE ; Ji-Woong KIM ; Seung-Jun KIM ; Na-Hyun LEE ; Hong-Seok OH
Korean Journal of Psychosomatic Medicine 2024;32(2):77-86
Objectives:
:This study was aimed to determine whether the presence or absence of psychotic symptoms inmood disorders is statistically significantly related to the difference between NLR, MLR, PLR.
Methods:
:We retrospectively reviewed the medical records of 408 patients who were hospitalized with a diagnosis of bipolar disorder type 1 (BP-I) and major depressive disorder (MDD) and underwent complete blood count.Groups were divided based on the presence or absence of psychotic symptoms. The statistical significance of the differences in NLR, MLR, and PLR between each group was examined using t-test.
Results:
:When 382 mood disorder patients were divided into groups based solely on the presence or absence ofpsychotic symptoms, the difference between NLR and MLR was statistically significant (NLR: p=0.009, MLR:p=0.016). When dividing the mood disorder patients into subgroups of 176 BP-I patients and 206 MDD patients and using the same method for each subgroup, the tendency for higher NLR and MLR was maintained, but the sta-tistical significance disappeared.
Conclusions
:This study suggests the possibility of relationship between psychotic symptoms and NLR and MLR in mood disorders, but additional research appears to be necessary to clarify the possibility.
10.Effect of Biliary Drainage on the Prognosis of Patients with Hepatocellular Carcinoma and Bile Duct Invasion
Keungmo YANG ; Hyun YANG ; Chang Wook KIM ; Hee Chul NAM ; Ji Hoon KIM ; Ahlim LEE ; U Im CHANG ; Jin Mo YANG ; Hae Lim LEE ; Jung Hyun KWON ; Soon Woo NAM ; Soon Kyu LEE ; Pil Soo SUNG ; Ji Won HAN ; Jeong Won JANG ; Si Hyun BAE ; Jong Young CHOI ; Seung Kew YOON ; Hee Yeon KIM
Gut and Liver 2024;18(5):877-887
Background/Aims:
Bile duct invasion (BDI) is rarely observed in patients with advanced hepatocellular carcinoma (HCC), leading to hyperbilirubinemia. However, the efficacy of pretreatment biliary drainage for HCC patients with BDI and obstructive jaundice is currently unclear. Thus, the aim of this study was to assess the effect of biliary drainage on the prognosis of these patients.
Methods:
We retrospectively enrolled a total of 200 HCC patients with BDI from multicenter cohorts. Patients without obstructive jaundice (n=99) and those who did not undergo HCC treatment (n=37) were excluded from further analysis. Finally, 64 patients with obstructive jaundice (43 subjected to drainage and 21 not subjected to drainage) were included. Propensity score matching was then conducted.
Results:
The biliary drainage group showed longer overall survival (median 10.13 months vs 4.43 months, p=0.004) and progression-free survival durations (median 7.00 months vs 1.97 months, p<0.001) than the non-drainage group. Multivariate analysis showed that biliary drainage was a significantly favorable prognostic factor for overall survival (hazard ratio, 0.42; p=0.006) and progression-free survival (hazard ratio, 0.30; p<0.001). Furthermore, in the evaluation of first response after HCC treatment, biliary drainage was beneficial (p=0.005). Remarkably, the durations of overall survival (p=0.032) and progression-free survival (p=0.004) were similar after propensity score matching.
Conclusions
Biliary drainage is an independent favorable prognostic factor for HCC patients with BDI and obstructive jaundice. Therefore, biliary drainage should be contemplated in the treatment of advanced HCC with BDI to improve survival outcomes.

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