Analysis Of Prognosis In Patients With Decompensated Cirrhosis By The Model For End-stage Liver Disease And Its Longitudinal Modifications

Objective The Model for End stage Liver Disease was originally developed to predict survival rates in patients with chronic liver disease undergoing trans-jugular intrahepatic portacaval shunt. The model, based on simple, readily available and reproducible variables, allowed identifying patients with survival as short as 3 and 6 months. In the series of patients from which it was calculated, the model was superior to both the Child-Pugh classification and the Child- Pugh score in predicting survival and its predictive accuracy. Recently, it has been suggested that the longitudinal modifications of the MELD score (AMELD) may reflect the progression of liver failure more reliably and therefore be more useful in prognostic assessment. This study was to assess the prognostic meanings of MELD and Zâ–³MELD in patients with decompensated liver cirrhosis.Methods A cohort of 168 patients with decompensated liver cirrhosis were retrospectively studied and followed up at least for four months. MELD and Child-Pugh score and classification was calculated at entry. MELD score was obtained for each patient according to the modified formula by Kamath. After initial assessment, all the patients had a second evaluation which was performed 1 month after initial evaluation.â–³MELD was calculated as MELD at second evaluation minus MELD at entry. Kaplan-Meier survival analysis was used to compare the survival in sub-groups ranked by the MELD score and â–³MELD. The area under the receiver operating characteristic (ROC) curve (AUC) was used to compare MELD, â–³MELD and Child- Pugh...