title: [Prognostic value of the model for end-stage liver disease combined with serum sodium levels in patients with decompensated cirrhosis].
abstract: OBJECTIVE
  To investigate the ability of the model for end-stage liver disease (MELD) score combined with serum sodium measurements to effectively evaluate the prognosis of patients with decompensated liver cirrhosis.
  
  
  METHODS
  A total of 212 patients with decompensated cirrhosis were retrospectively analyzed. Each patient's MELD scores, and sodium-based MELD scores (MELD-Na, MELDNa, and MESO) were calculated at three-month intervals. The area under the receiver operating characteristic (ROC) curve (AUC) was used to compare the predictive abilities of the four scores for 3-, 6- and 12-month mortality. Kaplan-Meier survival curves were created using the best cut-off values for each score identified by the ROC.
  
  
  RESULTS
  Among the 212 patients, 46 died within three months, 56 died within six months, and 87 died within 12 months. The MELD, MELD-Na, MELDNa and MESO scores were significantly different between patients who survived and those who died within three and 12 months (P less than 0.01). The AUCs for the four separate scores were all more than 0.8 at the 3- and 6-month time points; however, the AUCs of MELDNa (3-month: 0.846; 6-month: 0.869) and MESO (0.831; 0.850) were significantly better than those of MELD (0.812; 0.841) (P less than 0.05). At the 12-month time point, the AUCs of MELD, MELD-Na, MELDNa, and MESO were not significantly different (0.774, 0.775, 0.786, and 0.777, respectively). Survival curves showed that all the scores were able to clearly discriminate the patients who survived from those who died within 12 months (P=0.000).
  
  
  CONCLUSIONS
  The MELD score and its sodium-based variants (MELD-Na, MELDNa, and MESO) can precisely predict mortality of patients with decompensated cirrhosis for short and intermediate periods. The MELDNa and MESO scores are superior for predicting 3- and 6-month survival.
authors.affiliation: Department of Gastroenterology, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Jing-ying
authors.initials: JY
authors.lastname: Li
authors.forename: Qi
authors.initials: Q
authors.lastname: Deng
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Ming-yi
authors.initials: MY
authors.lastname: Xu
authors.forename: Lun-gen
authors.initials: LG
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058625:End Stage Liver Disease / Q000097:blood / Q000401:mortality; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood*
chemical_list: D012964:Sodium