title: EVALUATION OF MODEL FOR END-STAGE LIVER DISEASE SCORE CUT OFF VALUES IN PATIENTS WITH HEPATIC ENCEPHALOPATHY.
abstract: BACKGROUND
  Model for End Stage Liver Disease (MELD) is scoring system used for prioritization of patients waiting liver transplantation. Patients with decompensated chronic liver disease (DCLD) with higher MELD score and hepatic encephalopathy (HE) have poor outcome. We planned to note association between short-term mortality and various cut-off values of at admission MELD score in HCV related DCLD patients presenting with HE.
  
  
  METHODS
  In this descriptive case series, 208 Hepatitis C (HCV) related chronic liver disease (CLD) patients with HE were included. At admission serum bilirubin, creatinine and INR were sought to calculate MELD score. Patients who improved were discharged and kept under regular follow up. Outcome was categorized into alive or expired in 3 months after admission. Based on MELD score cut off values of > 15, > 20, > 25 and > 30, association with outcome was determined using Chi-square test.
  
  
  RESULTS
  One hundred and six (51%) patients were female. Mean patient age was 55.3 ± 10.6 years. Outcome wise, 128 (61.5%) were alive and 80 (38.5%) expired. Mean MELD score of expired was 22.17 ± 9.14. 55 (51%) patients with MELD score >15, 44 (65.7%) patients with > 20, 30 (73.2%) patients with > 25, and 21 (72.5%) patients with > 30 expired. MELD score > 20 had strongest association with outcome, p value less than 0.01.
  
  
  CONCLUSIONS
  At admission MELD score > 20 are most significantly associated with poor outcome in DCLD patients with HE.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Khurram
authors.forename: Wajeeha
authors.initials: W
authors.lastname: Qayyum
authors.forename: Muhammad
authors.initials: M
authors.lastname: Umar
authors.forename: Zain
authors.initials: Z
authors.lastname: ul Abedin
authors.forename: Hamama Tul
authors.initials: HT
authors.lastname: Bushra
mesh_terms: D058625:End Stage Liver Disease / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006501:Hepatic Encephalopathy / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index