title: Prognostic Significance of Ascites and Serum Sodium in Patients with Low Meld Scores.
abstract: OBJECTIVE
  to determine ascites and serum sodium significance in short term mortality prediction in patients with advanced liver cirrhosis.
  
  
  METHODS
  a cohort of 115 cirrhotic patients referred to our Department were followed up for 6 months in non-transplant settings. The c index equivalent to the area under the receiver operating curve (ROC) was calculated and compared to estimate the short-term prognostic accuracy of the following parameters: ascites, serum sodium and MELD score.
  
  
  RESULTS
  in patients with a MELD score less than 21, ascites and low serum sodium (c index 0,687, p<0 0,001 and 0,748, p<0,001 respectively) showed better prognostic accuracy and were independent predictors of mortality. For MELD scores above 21, only MELD was an independent mortality prognostic factor (c index 0,710, p<0,001).
  
  
  CONCLUSIONS
  in our study, sample ascites and low serum sodium help identify patients with advanced liver disease who are at high risk of mortality despite low MELD scores. These parameters should be considered as additional prognostic parameters that could improve available treatment options and outcomes in this group of patients.
authors.affiliation: Department of Gastroenterohepatology, University Clinical Center Sarajevo, Bosnia and Herzegovina.
authors.forename: Dzanela
authors.initials: D
authors.lastname: Prohic
authors.affiliation: Department of Gastroenterohepatology, University Clinical Center Sarajevo, Bosnia and Herzegovina.
authors.forename: Rusmir
authors.initials: R
authors.lastname: Mesihovic
authors.affiliation: Department of Gastroenterohepatology, University Clinical Center Sarajevo, Bosnia and Herzegovina.
authors.forename: Nenad
authors.initials: N
authors.lastname: Vanis
authors.affiliation: Department of Gastroenterohepatology, University Clinical Center Sarajevo, Bosnia and Herzegovina.
authors.forename: Amra
authors.initials: A
authors.lastname: Puhalovic
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications; D001201:Ascites / Q000097:blood / Q000175:diagnosis* / Q000401:mortality*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood*
chemical_list: D015415:Biomarkers; D012964:Sodium
keywords: ascites; cirrhosis; mortality; serum sodium MELD