Comparison of MELD, HVPG, and their changes to predict clinically relevant endpoints in cirrhosis

Abstract Aim. Identification of predictors in the natural history of cirrhosis is based on determinations at a fixed time point. However, changes of these predictors may offer more information. To evaluate the predictive value of Model for End Stage Liver Disease (MELD) and hepatic venous pressure gradient (HVPG) and their changes in cirrhosis. Methods. Patients with repeat HVPG measurements between January 2000 and December 2008 were considered for inclusion. Patients were followed until decompensation/death or July 2009. Multivariate Cox regression was used to analyze the predictive value of a single measurement of MELD and HVPG, and changes between measurements. Compensated and decompensated patients were analyzed separately. Results. One hundred and seventeen patients were included (51 compensated, 66 decompensated). Median time between measurements and follow-up was 13 (2–24) and 11 (6–38) months in compensated and 8 (1–16) and 10 (3–21) months in decompensated patients, respectively. Fifteen compens...