title: Model for end-stage liver disease combined with serum prealbumin to predict the prognosis of patients with decompensated liver cirrhosis.
abstract: OBJECTIVE
  To evaluate the prognostic value of model for end-stage liver disease (MELD) combined with serum prealbumin (PA) in patients with decompensated liver cirrhosis.
  
  
  METHODS
  A total of 252 patients were enrolled in the study and followed 1 year. PA was measured and MELD score was calculated on the first day of admission. Analysis of variance (anova) was used to assess correlation between PA level and MELD score. Multivariable Cox proportional hazards model was used to screen the prognosis related factors. Kaplan-Meier survival curves were drawn.
  
  
  RESULTS
  Of the 252 patients, 28 died within 3 months, 58 within 6 months and 91 within 1 year. Serum PA level in dead patients was significantly lower than that in survival patients (P < 0.005) and decreasing with increasing of MELD score. Cox analysis showed that MELD score > 18 (RR = 2.749) and PA < 70 mg/L (RR = 2.412) were independent prognosis risk factors. The risk ratio of MELD score combined with PA level (1.854, P < 0.01) was higher than that of MELD score alone (1.054, P < 0.05). Kaplan-Meier survival curve analysis showed that MELD score ≤ 18 combined with PA ≥ 70 mg/L could clearly discriminate patients who would survive or die within 6 month and 1 year follow up.
  
  
  CONCLUSIONS
  MELD score ≤ 18 combined with PA ≥ 70 mg/L could predict the 6-month and 1-year prognosis of patients with decompensated liver cirrhosis, and was superior to that of MELD score alone.
authors.affiliation: Department of Gastroenterology General Surgery, Shanghai East Hospital, Tongji University, Shanghai, China. liufeiguo2010@163.com
authors.forename: Fei
authors.initials: F
authors.lastname: Liu
authors.forename: Ling Yan
authors.initials: LY
authors.lastname: Cai
authors.forename: Lan
authors.initials: L
authors.lastname: Zhong
authors.forename: Chi
authors.initials: C
authors.lastname: Chen
authors.forename: Fei
authors.initials: F
authors.lastname: Xu
authors.forename: Zhong Xin
authors.initials: ZX
authors.lastname: Zhao
authors.forename: Xi Mei
authors.initials: XM
authors.lastname: Chen
mesh_terms: D058625:End Stage Liver Disease / Q000097:blood / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000097:blood / Q000401:mortality*; D015233:Models, Statistical; D015999:Multivariate Analysis; D011228:Prealbumin / Q000378:metabolism*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012720:Severity of Illness Index
chemical_list: D011228:Prealbumin