title: Model for end-stage liver disease score to serum sodium ratio index as a prognostic predictor and its correlation with portal pressure in patients with liver cirrhosis.
abstract: BACKGROUND
  The models for end-stage liver disease (MELD) and serum sodium (SNa) are important prognostic markers in cirrhosis. A novel index, MELD to SNa ratio (MESO), was developed to amplify the opposing effect of MELD and SNa on outcome prediction.
  
  
  METHODS
  A total of 213 cirrhotic patients undergoing hepatic venous pressure gradient (HVPG) measurement were retrospectively analyzed.
  
  
  RESULTS
  The MESO index correlated with HVPG (r=0.258, P<0.001) and Child-Pugh score (rho=0.749, P<0.001). Using mortality as the end point, the area under receiver operating characteristic curve (AUC) was 0.860 for SNa, 0.795 for the MESO index and 0.789 for MELD (P values all >0.3) at 3 months. Among patients with Child-Pugh class A or B, the MESO index had a significantly higher AUC compared with MELD (0.80 vs. 0.766, P<0.001). A MESO index <1.6 identified 97% of patients who survived at 3 months and the predicted survival rate was 96.5%. In survival analysis, MESO index >1.6 independently predicted a higher mortality rate (relative risk: 3.32, P<0001) using the Cox model.
  
  
  CONCLUSIONS
  The MESO index, which takes into account the predictive power of both MELD and SNa, is a useful prognostic predictor for both short- and long-term survival in cirrhotic patients.
authors.affiliation: Institute of Pharmacology, National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Teh-Ia
authors.initials: TI
authors.lastname: Huo
authors.forename: Ying-Wen
authors.initials: YW
authors.lastname: Wang
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Yang
authors.forename: Han-Chieh
authors.initials: HC
authors.lastname: Lin
authors.forename: Pui-Ching
authors.initials: PC
authors.lastname: Lee
authors.forename: Ming-Chih
authors.initials: MC
authors.lastname: Hou
authors.forename: Fa-Yauh
authors.initials: FY
authors.lastname: Lee
authors.forename: Shou-Dong
authors.initials: SD
authors.lastname: Lee
mesh_terms: D019540:Area Under Curve; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis*; D017093:Liver Failure / Q000175:diagnosis* / Q000401:mortality; D008954:Models, Biological; D017082:Portal Pressure; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood*; D015996:Survival Rate
chemical_list: D012964:Sodium