Model for the end-stage liver disease and death prediction in a cohort of Brazilian patients on the waiting list for liver transplantation.
OBJECTIVE
To examine the performance of the model for end-stage liver disease (MELD) score to predict mortality three and six months after enlistment of patients with chronic diseases for their first liver transplantation (LT) and to compare the performances of the Child-Turcotte-Pugh (CTP) and the Erasmus Model for End-stage Resistant-to-therapy All etiology Liver Disease (EMERALD) scores with the MELD to predict mortality.


METHODS
Cohort study. Receiver operating characteristics curve (ROC) curves were used to determine the ability of the scores for predicting three and six month mortality, the c-statistic to establish the predictive power of each score and the Cox proportional hazard model to estimate the risk of dying.


RESULTS
We studied 271 patients. At enlistment, the mean MELD and EMERALD scores were 14.8 and 26.6, respectively. Approximately 61% of the cases were in the CTP B category. During the three or six month follow-up period, the percentage of patients dying, receiving LT or remaining on the list were 11.8%, 9.2%, and 79.0% or 19.2%, 17.7%, and 63.1%, respectively. The three-month mortality was similarly predicted by the scores MELD, EMERALD and CTP (c-statistic of 0.79, 0.74, and 0.70, respectively). Six-month mortality presented similar AUC and ROC curves.


CONCLUSIONS
The scores predicted mortality for the three or six months, but the performance of the MELD was better than CTP and EMERALD scores.
Liver Transplantation Group, Complexo Hospitalar Santa Casa, School of Medicine, Universidade Federal do Rio Grande do Sul, RS, Brazil. ajaccio@via-rs.net
Ajacio
A
Brandão
Sandra C
SC
Fuchs
Ana L
AL
Gleisner
Claudio
C
Marroni
Maria L
ML
Zanotelli
Guido
G
Cantisani
D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D015331:Cohort Studies; D005260:Female; D006801:Humans; D017093:Liver Failure / Q000401:mortality*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D016017:Odds Ratio; D012372:ROC Curve; D012720:Severity of Illness Index; D014850:Waiting Lists; D055815:Young Adult