The Value Of MELD, MELD/SNa Ratio And IMELD In Predicting The Prognosis Of Patients With Cirrhosis

Objective To evaluate the value of Model for End-stage liver disease (MELD), MELD to Serum sodium ratio(MESO) and integrated MELD (iMELD) in assessing liver function reserve and predicting the short-term and medium-term prognosis of descompensated cirrhotic patients; to compare the capacity of MELD, MESO and iMELD in predicting short-term prognosis in decompensated liver cirrhotic patients.Methods 112 cases dencompensated liver cirrhotic patients were chosen for the retrospective cohort research,who had been admitted into digestive department of the Anhui Fuyang tumor hospital,between Januarary 2011 and December 2012. the information related were collected,using the registration form of clinic information, and the prognosis of each patient were obtained at the end of the follow-up.the MELD score,MESO ratio and iMELD score for each patient were calculated,according to the known formula, a retrospective cohort research of the liver cirrhotic patients with complete information were operated,evaluate the correlation of the three scoring systems, short-and median-term clinical outcome, the capacity of three scoring systems in estimating the prognosis of patients with decompensated liver cirrhosis was evaluated,using the receiver operating characteristic curve(ROC) and the area under the curve(AUC).Results The admission time as the start-point,death or the end of the research as the end-point.24 died(21.43%) during the follow-up,of which 18 died within the first 3mo,accounting for 75% of the total patients.Cox multi-factor anasysis indicate that HE,serum sodium less than 135mmol/L and age more than 60 year-old closely correlate with prognosis of patients with decompensated cirrhotic liver disease. MESO ratio, MELD score and iMELD score in 3mo death group is significantly higher than that of 3mo survival group (P<0.05).iMELD is superior to the MELD and MESO in predicting the 3mo and 6mo prognosis. AUC are 0.917、0.87、0.863 and 0.885、0.855、0.852 respectively (P<0.05)Conclusions MELD,MESO and iMELD are able to valuate liver function of patients with decompensated cirrhosis efficiently, MESO and iMELD are superior to MELD in predicting the short-and median-term prognosis. implying that serum sodium maybe an promising factor for prognosis of decompensated cirrhotic patients.