222 DIAGNOSTIC VALUE OF PRESEPSIN IN CIRRHOTIC PATIENTS

Background and Aims: A reduced EEG mean dominant frequency (MDF <7.3 Hz) is indicative of hepatic encephalopathy (HE). Since HE is not reflected in the MELD score and is an important prognostic parameter, the aim of this study was to assess the prognostic benefit of the addition of an EEG-based index to the MELD score. Methods: 392 consecutive patients with decompensated cirrhosis underwent an EEG with automated MDF determination. MELD was calculated at the time of EEG. Patients were excluded if they had advanced hepatocellular carcinoma, HE ≥ grade III or significant comorbidity. They were monitored for up to 18 months (median 12 months) in relation to the occurrence of death/lliver transplantation. The prognostic value of the stand-alone/combined MELD and MDF indices was calculated using standard survival analysis techniques (patients transplanted for hepatic decompensation were considered dead on the day of transplantation, those transplanted for hepatocellular carcinoma were censored). The findings were validated using a split sample technique: the Cox regression curve was re-calculated in a random sample of 259 patients, and the remaining 133 served as a test group. Results: During the follow-up period, 107 patients died/were transplanted for hepatic decompensation. Both the MELD and the MDF predicted mortality on Kaplan–Meier analysis, and both were independent predictors of mortality on a Cox model.