Comparison Study Of Five Scoring Systems In Evaluating Prognosis Of Patients Undergoing Transjugular Intrahepatic Portosystemic Shunt

Objective: To compare the model for end-stage liver disease(MELD),delta model for end-stage liver disease(?MELD), serum sodiumconcentration into model for end-stage liver disease score(MELD-Na),model for end-stage liver disease score to serum sodium ratio index(MESO)and integrated end-stage liver disease model(iMELD) on the medium-shortterm prognostic evaluation value in cirrhotic patients who underwenttransjugular intrahepatic portosystemic shunt(TIPS).Methods: A total of101patients with liver cirrhosis undergoing TIPSfrom January2011to May2013were enrolled and followed up for1month,3months and6months for the study. The MELD score, ?MELD score,MELD-Na score, MESO score and iMELD score were assessed accordingto the clinical data of each patient. The accuracy of the five scoring systemson predicting prognosis was analyzed and compared by the area under thereceiver operating characteristic(ROC)curve.Results:1?Until the cut-off time, the MELD, ?MELD, MELD-Na, MESO and iMELD score of survival group were (19.35±5.78),(2.47±1.38),(18.23±7.82),(1.57±0.43) and (33.76±9.58), while these five scores of thedeath group were (24.36±5.67),(4.35±1.61),(28.54±8.06),(2.16±0.59) and(48.05±12.64). The differences of these five scores had statisticalsignificance(P<0.01).2?With the increasing of scores of MELD, ?MELD, MELD-Na,MESO and iMELD, the survival rate of the patients correspondinglydecreased. The differences between the survival rate and survival curve ofeach group were of statistical significance(P<0.01).3?The area under the curve of MELD, ?MELD, MELD-Na, MESOand iMELD were0.735,0.769,0.803,0.740and0.816. The differencesbetween the areas of these five scores had no statisticalsignificance(P>0.05).Conclusions:1?The MELD scoring system,?MELD scoring system,MELD-Nascoring system,MESO scoring system and iMELD scoring system can allpredict the medium-short term prognosis well.2?There was no statistical significance difference in predictive valuesamong these five scores.