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MELD vs Child-Pugh and creatinine-modified Child-Pugh score for predicting survival in patients with decompensated cirrhosis.
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- Author(s): Papatheodoridis GV;Papatheodoridis GV; Cholongitas E; Dimitriadou E; Touloumi G; Sevastianos V; Archimandritis AJ
- Source:
World journal of gastroenterology [World J Gastroenterol] 2005 May 28; Vol. 11 (20), pp. 3099-104.- Publication Type:
Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 100883448 Publication Model: Print Cited Medium: Print ISSN: 1007-9327 (Print) Linking ISSN: 10079327 NLM ISO Abbreviation: World J Gastroenterol Subsets: MEDLINE
- Publication Information: Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group
Original Publication: Beijing : WJG Press, c1998- - Subject Terms:
- Abstract: Aim: Model of End-stage Liver Disease (MELD) score has recently gained wide acceptance over the old Child-Pugh score in predicting survival in patients with decompensated cirrhosis, although it is more sophisticated. We compared the predictive values of MELD, Child-Pugh and creatinine-modified Child-Pugh scores in decompensated cirrhosis.
Methods: A cohort of 102 patients with decompensated cirrhosis followed-up for a median of 6 mo was studied. Two types of modified Child-Pugh scores estimated by adding 0-4 points to the original score using creatinine levels as a sixth categorical variable were evaluated.
Results: The areas under the receiver operating characteristic curves did not differ significantly among the four scores, but none had excellent diagnostic accuracy (areas: 0.71-0.79). Child-Pugh score appeared to be the worst, while the accuracy of MELD was almost identical with that of modified Child-Pugh in predicting short-term and slightly better in predicting medium-term survival. In Cox regression analysis, all four scores were significantly associated with survival, while MELD and creatinine-modified Child-Pugh scores had better predictive values (c-statistics: 0.73 and 0.69-0.70) than Child-Pugh score (c-statistics: 0.65). Adjustment for gamma-glutamate transpeptidase levels increased the predictive values of all systems (c-statistics: 0.77-0.81). Analysis of the expected and observed survival curves in patients subgroups according to their prognosis showed that all models fit the data reasonably well with MELD probably discriminating better the subgroups with worse prognosis.
Conclusion: MELD compared to the old Child-Pugh and particularly to creatinine-modified Child-Pugh scores does not appear to offer a clear advantage in predicting survival in patients with decompensated cirrhosis in daily clinical practice. - References: Hepatology. 2002 May;35(5):1179-85. (PMID: 11981768)
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- Publication Date: Date Created: 20050527 Date Completed: 20050623 Latest Revision: 20190430
- Publication Date: 20231215
- Accession Number: PMC4305847
- Accession Number: 10.3748/wjg.v11.i20.3099
- Accession Number: 15918197
- Source:
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