title: MELD-Na: effective in predicting rebleeding in cirrhosis after cessation of esophageal variceal hemorrhage by endoscopic therapy.
abstract: OBJECTIVE
  There is no study verifying the predictive value of model for end-stage liver disease and sodium (MELD-Na) for rebleeding and its associated mortality in cirrhotic patients after cessation of acute esophageal variceal hemorrhage (AVH) by endoscopic therapy. This study aimed to determine the predictive value of MELD-Na by comparing with MELD or Child-Turcotte-Pugh (CTP) scores.
  
  
  METHODS
  Consecutive adult cirrhotic patients after cessation of AVH by endoscopic therapy (endoscopic variceal ligation or sclerotherapy injections) within 48 hours of admission admitted from 2003 to 2012 were analyzed. The clinical characteristics and laboratory data at admission were documented, based on which MELD-Na, MELD, and CTP scores were calculated.
  
  
  RESULTS
  Among 429 patients who had complete control of AVH, 97 patients (22.6%) suffered esophageal variceal rebleeding within 3 months and 206 patients (48.0%) within 1 year. Fifty-three patients (12.4%) died within 3 months and 98 patients (22.8%) within 1 year from rebleeding. The area under receiver operator characteristics curve of the MELD-Na score for predicting rebleeding and its associated mortality was significantly higher than that of the MELD and the CTP score (rebleeding: 0.83 vs. 0.77 vs. 0.69 for 3 months and 0.85 vs. 0.80 vs. 0.65 for 1 year, P<0.05; mortality: 0.81 vs. 0.75 vs. 0.66 for 3 months and 0.82 vs. 0.78 vs. 0.68 for 1 year, P<0.05).
  
  
  CONCLUSIONS
  The MELD-Na score is clinically useful in predicting 3-month and 1-year rebleeding and its associated mortality in cirrhotic patients after cessation of AVH by endoscopic therapy.
authors.affiliation: Department of Gastroenterology and Hepatology, the First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: An-Jiang
authors.initials: AJ
authors.lastname: Wang
authors.forename: Bi-Min
authors.initials: BM
authors.lastname: Li
authors.forename: Zhi-Jian
authors.initials: ZJ
authors.lastname: Liu
authors.forename: Lu
authors.initials: L
authors.lastname: Chen
authors.forename: He
authors.initials: H
authors.lastname: Wang
authors.forename: Feng
authors.initials: F
authors.lastname: Shi
authors.forename: Xuan
authors.initials: X
authors.lastname: Zhu
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002681:China; D058625:End Stage Liver Disease / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D008026:Ligation; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015911:Sclerotherapy; D012964:Sodium / Q000097:blood*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D012964:Sodium