[Comparison of CTP, MELD, and MELD-Na scores for predicting short term mortality in patients with liver cirrhosis].
OBJECTIVE
MELD-Na (model for end-stage liver disease with incorporation of serum sodium) was suggested to provide better survival prediction than MELD alone for patients with end stage liver disease. However, there is no data verifying the usefulness of MELD-Na for predicting short term mortality of cirrhotic patients in Korea. This study was aimed to determine whether MELD-Na would be more accurate in predicting short term mortality than other scoring systems such as Child-Turcotte-Pugh (CTP) or MELD.


METHODS
Data from 355 patients admitted due to liver cirrhosis were retrospectively reviewed. The cumulative survival rates were obtained. Prediction of mortality rate for three months and one year were analyzed using the area under the receiver's operating characteristics curve (AUC).


RESULTS
One hundred patients (28%) died during the study period. All of the three systems showed significant differences in the cumulative survival rate according to the scores on admission (p0.001). The AUC of CTP, MELD, and MELD-Na in predicting three-months mortality were 0.828, 0.845, and 0.862 (p0.05), and the AUC of each score system for death within one year were 0.792, 0.800, and 0.831, respectively (p0.05). The AUC of MELD-Na in predicting short term death were the highest, although it was not statistically significant. Multivariate analysis showed that only MELD-Na was significantly related to three-month mortality (p=0.012).


CONCLUSIONS
MELD-Na is more appropriate in predicting short term mortality, but larger scale studies are needed to confirm the superiority of MELD-Na to MELD and CTP in patients with liver cirrhosis.
Kim
Se Yune
SY
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Yim
Hyung Joon
HJ
Lee
Juneyoung
J
Lee
Beom Jae
BJ
Kim
Dong Il
DI
Jung
Sung Woo
SW
Han
Woo Sik
WS
Lee
Jong Sup
JS
Koo
Ja Seol
JS
Seo
Yeon Seok
YS
Yeon
Jong Eun
JE
Lee
Hong Sik
HS
Lee
Sang Woo
SW
Um
Soon Ho
SH
Byun
Kwan Soo
KS
Choi
Jai Hyun
JH
Ryu
Ho Sang
HS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors