[Comparison of the Model for End-stage Liver Disease and hepatic venous pressure gradient for predicting survival in patients with decompensated liver cirrhosis].
OBJECTIVE
This study compared the prognostic values of the Model for End-stage Liver Disease (MELD) and the hepatic venous pressure gradient (HVPG) in the prediction of death within 3 and 12 months in patients with decompensated liver cirrhosis.


METHODS
We used data from 136 consecutive patients with decompensated cirrhosis who underwent HVPG between January 2006 and June 2008. Cox regression analysis was used to investigate the independent relationships with death of MELD and HVPG. The prognostic accuracies of MELD and HVPG were analyzed by calculating the area under the receiver operating characteristic curve (AUROC) for the occurrence of death within 3 and 12 months.


RESULTS
Both MELD and HVPG were independent predictors of death [hazard ratio (HR)=1.11 and 1.12, respectively; 95% confidence interval (CI)=1.04~1.20 and 1.08-1.16]. Analysis of the AUROC demonstrated that the prognostic power did not differ between MELD and HVPG for predicting the 3-month survival (HR=0.76 and 0.68, respectively; 95% CI=0.62~0.89 and 0.52~0.84; P=0.22) or the 12-month survival (HR=0.72 and 0.73, 95% CI=0.61~0.83 and CI=0.61~0.84).


CONCLUSIONS
Both MELD and HVPG are independent prognostic factors of death within 3 and 12 months in patients with decompensated liver cirrhosis, and their accuracies are similar. However, HVPG has a limited role in the prediction of death in decompensated cirrhosis due to its invasiveness and limited use.
Lee
Sung Hoa
SH
Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
Park
Seung Ha
SH
Kim
Go Woon
GW
Lee
Woo Jin
WJ
Hong
Won Ki
WK
Ryu
Myeong Shin
MS
Park
Kyu Tae
KT
Lee
Min Young
MY
Lee
Chan Woo
CW
Kim
Jin Ho
JH
Kim
Yong Mook
YM
Kim
Sung Jung
SJ
Baik
Gwang Ho
GH
Kim
Jin Bong
JB
Kim
Dong Joon
DJ
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015331:Cohort Studies; D005260:Female; D006503:Hepatic Veins / Q000503:physiopathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D017093:Liver Failure / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D014690:Venous Pressure