Evaluation Value Of MELD Combined With APRI Score In Short-term Prognosis Of Patients With Decompensated Cirrhosis

Objective To explore the predictive value and clinical significance of MELD combined with APRI score in the short-term prognosis of patients with decompensated cirrhosis.Methods In this project,189 patients with decompensated liver cirrhosis who were hospitalized in Sinopharm Gezhouba Central Hospital from June 2013 to June 2018 were selected,and established a clinical data table,followed up for 1 year,of which excluding 26 cases(14 cases lost to follow-up,7 cases died due to other diseases,5 cases with poor compliance),163 cases that met the inclusion criteria were divided into death group(35 cases)and survival group(128 cases)according to the follow-up results(survival or not),comparing the differences of general data between the two groups(including gender,age,platelet(PLT),aspartate aminotransferase(AST),total bilirubin(TBIL),international normalized ratio of prothrombin(INR),Blood creatinine(Cr)indicators,etc.),MELD and APRI score;The ROC curve was used to compare the APRI score,MELD score,and the combination of the two to predict prognosis of patients;according to the results of ROC curve,Kaplan-Meier survival curve and survival analysis were made.Results1)In the comparison of general data,there was no significant difference in age,gender,and platelet count between the death group and the survival group(P>0.05).There was a difference in the comparison of etiology,aspartate aminotransferase,serum creatinine,total bilirubin,and INR between the two groups,All were statistically significant(P<0.05).2)The APRI score of patients with decompensated liver cirrhosis in the death group was significantly higher than that in the survival group(2.74±1.41 vs.1.56±0.81,P<0.05).The MELD score of the death group was significantly higher than that of the survival group(14.34 ± 4.00 vs.10.94 ± 2.98,P <0.001).3)The area under the ROC curve of MELD,APRI score and the combination of the two are are 0.737(95% CI: 0.631～0.843),0.756(95% CI: 0.672～0.841),and 0.841(95% CI: 0.769 ～ 0.913),respectively.At the same time,the results of the two comparisons showed that the combination of the two and the MELD or APRI scores were statistically significant(P <0.05),while the difference in MELD and APRI scores was not statistically significant(P>0.05).The cut-off values of MELD and APRI scores were 15,1.35,respectively.4)In the survival curve established by combining the two groups,the results show that the first group(MELD<15 and APRI<1.35)has the lowest mortality rate,the second group(MELD<15 and APRI≥1.35)and the third group(MELD≥15 and APRI<1.35)mortality is similar,the fourth group(MELD≥15 and APRI≥1.35)has the highest mortality.Conclusion1)The APRI score in the death group is significantly higher than that of the survival group.The higher the APRI score,the worse the prognosis.2)The MELD score in the death group is significantly higher than that of the survival group.The higher the MELD score,the worse the prognosis.3)The MELD combined with APRI score can improve the predictive ability of short-term prognosis in patients with decompensated cirrhosis.