MELD Score And Addition Of Serum Sodium Into The MELD Score Predict The Short-term Mortality Of Cirrhosis

In order to select correct therapy proposal suitting for different end-stage liver disease, physicians need a available, reproducible, and objective mode to judge pathogenetic condition of patients.As more new methods, especially orthotopic liver transplantation, for treating end-stage liver disease appearring, CTP can not satisfy the require- ment of physicians. Since February 2002, allocation of organ donors in the United States has based on the MELD score as the new standard for orthotopic liver transplantation substituting CTP.After five years,the efficient of MELD in guiding liver transplantation has been accredited.But if it can substitute CTP in prediction of prognosis in patients with liver cirrhosis, physician has not reached coincident opinion.In order to increase the efficient of MELD in prediction of prognosis,some scholars proposed to inprove it with addition of serum sodium . The aim of our study is to evaluate the short-term prognosis of liver cirrhotic patients by using MLLD scoe and addition of serum sodium into the MELD Score. Methods:the data of 107 cirrhotic patients were analyzed with a cohort method retrospectively and the followup period was at least three months. Serum sodium, Serum bilirubin, INR, Serum creatinine, CTP score, MELD score were compared in two terms and area under of receiver operatingcharacteristic curve (ROC) was used to compare the value of CTP,MELD and addition of serum sodium into the MELD Score for predicting the prognosis. Results: Twenty -nine (27.1%)patients died in three months, Serum sodium, serum bilirubin, INR, serum creatinine, CTP score and MELD score of non-surviors were higher than those of survivors significantly (p<0.01). Among four terms of different MELD scores(<10, 10-19, 20-29,≥30), serum sodium was better than serum creatinine to evaluate the short-term prognosis in the middle two terms (p<0.05). Area under the ROC of MELD (0.81) was significantly(p<0.05) different from that of CTP (0.74), and area under the ROC of addition of serum sodium into the MELD (0.86) was significantly(p<0.05) different from that of MELD (0.81). Conclusion: MELD grading is an objective and efficient predictive system for short-term survival. It is more efficient than CTP for short-term prognosis of liver cirrhotic patients and is worth using in clincal setting in China. Addition of serum sodium into the MELD can approve the efficacy for short-term prognosis.