[Model for end-stage liver disease-sodium predicts prognosis in patients with chronic severe hepatitis B].
OBJECTIVE
To study the practical use of the serum sodium incorporated model for end-stage liver disease (MELD-Na) on clinic and to assess its validity by the concordance-statistic in predicting the prognosis of the patients with chronic severe hepatitis B.


METHODS
Adult patients with a diagnosis of chronic severe hepatitis B between January 2007 and December 2007 in a single center were analyzed. The serum sodium, MELD, MELD-Na, and Delta MELD-Na (Delta MELD=MELD score at 14 days after medical treatment-MELD score at admission) scores of 426 patients with chronic severe hepatitis B were calculated. The 3-month mortality in patients was measured, and the validity of the models was determined by means of the concordance-statistic.


RESULTS
The area under the receiver-operating characteristic curves of Na, MELD and MELD-Na for the occurrence of death in 3 month were 0.718, 0.875 and 0.922. The 3-month mortality of the MELD-Na scores group <25, 25-30, >30-35, >35- <40 and > or = 40 were 2.0%, 5.4%, 35.4%, 53.8% and 86.9% respectively. There was a significant difference of 3-month mortality between the five groups (P<0.05). The 3-month mortality of Delta MELD-Na> 0 group was 65.9%, and the Delta MELD-Na < or = 0 group was 15.8%. There was a significant difference of 3-month mortality between the two groups (P<0.05).


CONCLUSIONS
MELD-Na score is a valid model to predict 3-month mortality in patients with chronic severe hepatitis B. Delta MELD-Na is clinically useful parameters for predicting the therapeutic effect of chronic severe hepatitis B.
Chen
Hu-an
HA
Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Transplantation Institute of Sun Yat-sen University, Guangzhou 510630, China.
Chen
Ying-hua
YH
Zhao
Hui
H
Yi
Shu-hong
SH
Zhang
Jun-feng
JF
Meng
Wei
W
Cai
Chang-jie
CJ
Lu
Min-qiang
MQ
Chen
Gui-hua
GH
D000293:Adolescent; D000328:Adult; D000368:Aged; D058625:End Stage Liver Disease; D005260:Female; D005500:Follow-Up Studies; D019694:Hepatitis B, Chronic / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult