LC, Acute : O-057 ; The comparison of HVPG, MELD-Na, and Child-Pugh score for the prediction of mortality in patients with liver cirrhosis

Background/Aim: Measurement and assessment of portal hypertension are very important in the caring of patients with liver cirrhosis and in predicting relevant prognosis. This study compared the prognostic values of hepatic venous pressure gradient (HVPG), model for end-stage liver disease (MELD)- Na, and Child-Pugh score for the prediction of mortality in patients with liver cirrhosis. Methods: We investigated 136 patients with liver cirrhosis who underwent HVPG between July 2009 and March 2012. Clinical variables including laboratory data, presence of ascites, HVPG, MELD-Na, and Child-Pugh score were collected and analyzed. Cox regression model was developed to identify predictors of mortality. Accuracy of prediction was analyzed using the area under the receiver’s operating characteristics curve (AUROC). Results: HVPG, MELD-Na, Child-Pugh score, hemoglobin, HDL, albumin, and PIVKA2 significantly predicted overall mortality (univariate analysis, p<0.05). MELD-Na was an independent prognostic factor for prediction of overall mortality (multivariate HR; 23.569; p=0.043). Additionally, ascites was an independent prognostic factor for 6 month mortality (multivariate HR; 5.160; p<0.001), MELD-Na and ascites were independent prognostic factors for 12 month mortality (multivariate HR; 1.845, 1.974; p=0.030, p=0.016). AUROC was 0.698 for HVPG, 0.705 for MELD-Na, 0.591 for Child-Pugh score, respectively (p=0.015, p=0.012, p=0.266). Conclusion: MELD-Na is superior than HVPG and CTP score for the prediction of mortality in patients with liver cirrhosis.