Evaluation Of Indocyanine Green Clearance Test(ICGR₁₅) And Model For End-stage Liver Disease(MELD) For Estimation Of Short-term Prognosis In Patients With Liver Failure

Objective:To investigate the correlations between Indocyanine green clearance test (ICGR15) and MELD scores, and evaluate the prognostic value of them in patients with liver failure.Methods:102 patients with liver failure were screened. Routine laboratory parameters were analyzed, MELD scores were calculated, and ICGR15 values were conducted within one week by Pulse Dye Densitograph Analyzer(DDG).90-day mortality rate was observed. ICGR15 values and MELD scores between survival group and died group were compared. Correlation between ICGR15 values and MELD scores was evaluated by Spearman test. The diagnostic accuracy of ICGR15 values and MELD scores for prediction of 90-day survival was assessed by receiver-operating characteristic (ROC) curve analysis.Results:With the degree of liver failure became gradually serious, ICGR15 values and MELD scores were increased accordingly(P<0.01)34.3% of the patients died within 90 days, MELD scores and ICGR15 values for deaths were higher than those for survivors significantly (P<0.01).Positive correlation was observed between ICGR15 values and MELD scores(r= 0.274).Area under the ROC of MELD scores was higher than that of ICGR15 values for 90-day term (AUC 0.833 vs.0.705) (P>0.05). ROC analysis revealed the cut-offs predicting mortality rate in the patients with liver failure were ICGR15 values:52.1% (sensitivity:71.4%; specificity:62.7%) and MELD scores:31.5 (sensitivity:65.7%; specificity:86.6%). Mortality of them was 50% when ICGR15 values≥52.1% compared with 19.2% when ICGR15 values<52.1%(χ2=10.71, P<0.01), and 17.1% when MELD scores<32 compared with 71.9% when MELD scores≥32(χ2=29.19, P＜0.01).Conclusions:Both MELD scores and ICGR15 values can accurately predict the short-term prognosis of patients with liver failure, ICGR15 values has positive correlation with MELD scores.MELD scores are equal to ICGR15 values for short-term prognosis. Specificity of the former is superior to that of the latter, but Sensitivity is inferior. Combing MELD scores with ICGR15 values might be helpful in predicting the short-time outcome in liver failure.