Application of an end-stage liver disease model in prediction of prognosis in patients with liver cirrhosis

AIM: To evaluate the short- and medium-term prognosis of liver cirrhotic patients by using the model for end-stage liver disease (MELD). METHODS: The data of 199 cirrhotic patients were analyzed with a cohort method retrospectively and the followup period was at least one year. Both MELD score and Child-Pugh score were computed for each patient according to the original formula on admission day. Area under of receiver operating characteristic curve (ROC) was used to compare the value of MELD score with Child-Pugh’s for predicting the prognosis. Kaplan-Meier survival curves were made using the cut-offs identified by means of ROC. MELD values were correlated with Child-Pugh scores. RESULTS: Thirty-seven patients died in three months, MELD scores and Child-Pugh scores for non-survivors (23.4± 9.90, 10.8±2.29) were higher than those for survivors (14.3± 4.66, 8.68±2.21) significantly (P 0.05) between MELD value (0.758) and Child-Pugh score (0.724). Survival curves showed both MELD and Child-Pugh scores was clearly discriminated between patients who survived and those who died in short term as well as in the medium term (P <0.001). MELD grading system showed significant correlation with Child-Pugh scores (r =0.69, P <0.001). CONCLUSION: MELD grading is an objective predictive system for both short- and medium- term survival. It is more efficient than Child-Pugh score for short-term prognosis and is worth using in clinical setting. Xiong WJ, Liu F, Zhao ZX, Qiu DK. Application of an end-stage liver disease model in prediction of prognosis in patients with liver cirrhosis. Shijie Huaren Xiaohua Zazhi 2004;12(5):1159-1162