Comparison of the model for end-stage liver disease and disease sodium values in prognosticating short term 3-month mortality in chronic liver disease
DOI:
https://doi.org/10.18203/2320-6012.ijrms20222267Keywords:
Mortality in CLD, MELD score, MELD-Na scoreAbstract
Background: Chronic liver disease (CLD) cirrhosis of liver is one of the common non communicable disease, accounting for significant morbidity and mortality in developing countries like India. several prognostic scoring systems have evolved from the need to prioritize patients for liver transplantation model for end-stage liver disease (MELD) and its variant, which includes sodium values (MELD-Na) have been recently popularized.
Methods: Prospective observational study with follow-up telephone call every month for 3 months, with ppurposive sampling done on 60 patients admitted to AIMS BG Nagara Mandya district Karnataka India. Statistical analysis included the strength of association was assessed using Pearson's correlation and the ROC curve was drawn to assess the accuracy and diagnostic utility of the two models. A p<0.05 was considered statistically significant.
Results: In the present study, the mean age of patients was 49.68±9.89 years of age. The strength of association between the MELD score and MELD-Na score was found to be a very strong positive strength of association (r=0.904, p<0.05). The mean MELD score and MELD-Na score was found to be higher in non-survivors’ group (28.5 and 30.5) compared to survivors group (22.03 and 25.67) which was statistically very significant.
Conclusions: MELD-Na score was higher among the patients with outcome of death compared to the MELD score among the patient. The ROC curve showed a comparable result with MELD and MELD-Na scores. There was a relation of severity of hyponatremia with the child-Pugh scores.
Metrics
References
Jain M, Varghese J, Kedarishetty C, Srinivasan V, Venkataraman J. Incidence and risk factors for mortality in patients with cirrhosis awaiting liver transplantation. Indian J Transplant. 2019;13(3):210-5.
Kim WR, Biggins SW, Kremers WK, Wiesner RH, Kamath PS, Benson JT et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008;359(10):1018-26.
Samuel D. MELD-Na as a prognostic score for cirrhotic patients: Hyponatremia and ascites are back in the game. J Hepatol. 2009;50(4):836-8.
Londoño M-C, Cárdenas A, Guevara M, Quintó L, de Las Heras D, Navasa M et al. MELD score and serum sodium in the prediction of survival of patients with cirrhosis awaiting liver transplantation. Gut. 2007;56(9):1283-90.
Hsu C-Y, Lin H-C, Huang Y-H, Su C-W, Lee F-Y, Huo T-I et al. Comparison of the model for end-stage liver disease (MELD), MELD-Na and MELDNa for outcome prediction in patients with acute decompensated hepatitis. Dig Liver Dis. 2010;42(2):137-42.
Ruf AE, Kremers WK, Chavez LL, Descalzi VI, Podesta LG, Villamil FG. Addition of serum sodium into the MELD score predicts waiting list mortality better than MELD alone. Liver Transpl. 2005;11(3):336-43.
Peng Y, Qi X, Guo X. Child-Pugh Versus MELD Score for the Assessment of Prognosis in Liver Cirrhosis: A Systematic Review and Meta-Analysis of Observational Studies. Medicine (Baltimore). 2016;95(8):e2877.
Pozo-Laderas JC, Rodríguez-Perálvarez M, Muñoz-Villanueva MC, Rivera- Espinar F, Durban-García I, Muñoz-Trujillo J et al. Pretransplant predictors of early mortality in adult recipients of liver transplantation in the MELD-Na Era. Med intensiva. 2019;43(5):261-9.
Mukherjee T, Nataraju KT, Rakesh BM, Dandothi SD. Comparison of model for end-stage liver disease-Na score and model for end-stage liver disease score in predicting in-hospital mortality in patients with end stage liver disease: an observational study. Int J Adv Med. 2019;6(3):932-6.
Mazumder NR, Atiemo K, Daud A, Kho A, Abecassis M, Levitsky J et al. Patients with Persistently Low MELD-Na Scores Continue to Be at Risk of Liver-related Death. Transplantation. 2020;104(7):1413-8.
Tripodi A, Chantarangkul V, Primignani M, Fabris F, Dell’Era A, Sei C et al. The international normalised ratio calibrated for cirrhosis (INR(liver)) normalises prothrombin time results for model for end-stage liver disease calculation. Hepatology. 2007;46(2):520-7.
Chen S-H, Wan Q-S, Wang T, Zhang K-H. Fluid Biomarkers for Predicting the Prognosis of Liver Cirrhosis. Biomed Res Int. 2020;2020:7170457.
Bellest L, Eschwège V, Poupon R, Chazouillères O, Robert A. A modified international normalised ratio as an effective way of prothrombin time standardisation in hepatology. Hepatology. 2007;46(2):528-34.
Manka P, Bechmann LP, Tacke F, Sowa J-P, Schlattjan M, Kälsch J et al. Serum sodium based modification of the MELD does not improve prediction of outcome in acute liver failure. BMC Gastroenterol. 2013;13(1):58-62.
Heuman DM, Abou-Assi SG, Habib A, Williams LM, Stravitz RT, Sanyal AJ et al. Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death. Hepatology. 2004;40(4):802-10.
Luca A, Angermayr B, Bertolini G, Koenig F, Vizzini G, Ploner M et al. An integrated MELD model including serum sodium and age improves the prediction of early mortality in patients with cirrhosis. Liver Transpl. 2007;13(8):1174-80.
Downloads
Published
How to Cite
Issue
Section
