Combined MELD and blood lipid level in evaluating the prognosis of decompensated cirrhosis.
OBJECTIVE
To evaluate the prognostic value of the combined model for end-stage liver disease (MELD) and blood lipid level in patients with decompensated cirrhosis.


METHODS
A total of 198 patients with decompensated cirrhosis were enrolled into the study. The values of triglyceride (TG), cholesterol (TC), high density lipoproteins (HDL) and low density lipoprotein (LDL) of each patient on the first day of admission were retrieved from the medical records, and MELD was calculated. All the patients were followed up for 1 year. The relationship between the change of blood lipid level and the value of MELD score was studied by analysis of variance. The prognostic factors were screened by multivariate Cox proportional hazard model. Draw Kaplan-Meier survival curves were drawn.


RESULTS
Forty-five patients died within 3 mo and 83 patients died within 1 year. The levels of TG, TC, HDL and LDL of the death group were all lower than those of the survivors. The serum TG, TC, HDL and LDL levels were lowered with the increase of the MELD score. Multivariate Cox proportional hazard model showed that MELD >or= 18 and TC <or= 2.8 mmol/L were independent risk factors for prognosis of decompensated cirrhosis. Survival analysis showed that MELD >or= 18 combined with TC <or= 2.8 mmol/L can clearly discriminate between the patients who would survive and die in 1 year.


CONCLUSIONS
MELD >or= 18 and TC <or= 2.8 mmol/L are two important indexes to predict the prognosis of patients with decompensated cirrhosis. Their combination can effectively predict the long-term prognosis of patients with decompensated cirrhosis.
Jiang
Ming
M
Department of Gastroenterology, Shanghai East Hospital Affiliated to Tongji University, 150 Jimo Road, Shanghai 200120, China.
Liu
Fei
F
Xiong
Wu-Jun
WJ
Zhong
Lan
L
Xu
Wen
W
Xu
Fei
F
Liu
Yan-Bing
YB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008055:Lipids / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood / Q000401:mortality / Q000503:physiopathology; D017093:Liver Failure / Q000097:blood / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models
D008055:Lipids