Significance Of Baseline And Dynamic MELD、MELD-Na Score In The Short-term Prognosis Of Liver Failure

Objective:Comparison of baseline and dynamic model for end-stage liver disease (MELD) and MELD-Na score in the short-term prognosis of liver failure, and look for a better prognostic methods.Methods:Retrospective analy the clinical data of322cases of liver failure, different stages of MELD,MELD-Na score with△MELD and△MELD-Na were separate calculated in different types of liver failure, patients were divided into survival group and fatal group according to the3rd month status, using receiver operating characteristic curve analysis to predict the value of each model. Results:The prognosis of acute, subacute, acute-on-chronic and chronic liver failure are quite different(χ2=14.273, P=0.001), the short-term mortality was followed by77.4%,41.7%and56.1%.In acute and subacute liver failure, when compared with each other all the scoring system P>0.05,so we can not evaluate the merits of each scoring system; In acute-on-chronic liver failure,△MELD and△MELD-Na score AUC were0.889,0.897, respectively, without significant difference (Z=0.310. P=0.7562); In chronic liver failure,△MELD score has the better results (AUC=0.871, sensitivity and specificity were0.740,0.893) than△MELD-Na score (Z=4.229, P<0.05). Conclusion:In acute, subacute liver failure, each score can predict the prognosis, but no significant difference between them, pending further studies support; MELD and MELD-Na score have similar prediction capabilities,△MELD and△MELD-Na score have good predictive power in acute-on-chronic liver failure; As to chronic liver failure, MELD score is better than MELD-Na score and△MELD score predicts good accuracy.