title: Performance of the new MELD-Na score in predicting 3-month and 1-year mortality in Chinese patients with chronic hepatitis B.
abstract: The new Model for End-Stage Liver Disease (MELD)-Na score has been validated in a population predominantly affected by chronic hepatitis C and alcoholic liver disease. We aimed to validate the score in Chinese patients with chronic hepatitis B-related complications admitted to the hospital from 1996 to 2003. MELD and the new MELD-Na scores (MELD-Na = MELD + 1.59 [135 - Na] with maximum and minimum Na of 135 and 120 mmol/L, respectively) on initial admissions were calculated. Cox proportional hazard model was used to assess factors associated with mortality. The area under the receiver operator characteristic curve (AUC) was used to compare the predictive abilities of MELD and MELD-Na scores for 3-month and 1-yr mortalities. Patients with hepatocellular carcinoma were excluded. A total of 2,073 patients with liver disease were admitted during the study period and 363 patients had chronic hepatitis B-related complications other than hepatocellular carcinoma. At a median follow-up of 106 weeks, 134 patients died and 14 received liver transplantation. Patients with MELD-Na scores 11-20, 21-30, and >30 had mortality increased by 2.0-fold, 4.7-fold, and 7.6-fold, respectively, compared to patients with scores < or =10. At 3 months and 1 yr, the AUC of the MELD-Na score (0.75 and 0.79, respectively) was superior to those of the MELD score (0.72 and 0.75, respectively) (P = 0.004) in predicting mortality. In conclusion, the new MELD-Na score is a valid model to predict mortality in patients with complications of chronic hepatitis B.
authors.affiliation: Institute of Digestive Disease and Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Republic of China.
authors.forename: Vincent Wai-Sun
authors.initials: VW
authors.lastname: Wong
authors.forename: Angel Mei-Ling
authors.initials: AM
authors.lastname: Chim
authors.forename: Grace Lai-Hung
authors.initials: GL
authors.lastname: Wong
authors.forename: Joseph Jao-Yao
authors.initials: JJ
authors.lastname: Sung
authors.forename: Henry Lik-Yuen
authors.initials: HL
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D005260:Female; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood; D013997:Time Factors
chemical_list: D000998:Antiviral Agents; D012964:Sodium