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[Clinical usefulness of DeltaMELD to predict the survival of patients with liver cirrhosis].
Korean J Hepatol. 2006 Dec; 12(4):530-8.KJ

Abstract

BACKGROUNDS/AIMS

The change of MELD (Model for End-stage Liver Disease) score over time (DeltaMELD) has been proposed as a tool to predict the survival in cirrhotic patients. The aims of the study were to assess ability of the DeltaMELD to predict the survival and compare them with the initial MELD and CP score.

METHODS

MELD score was serially determined at least twice with more than two-month interval in 120 cirrhotic patients. We analyzed the clinical factors associated with the variation of MELD score. The predictive power of 6, 12 and 24 months mortality for DeltaMELD, initial MELD and CP score was compared by c-statistics. Patient survival was also compared at 6, 12 and 24 months according to the cut off values of DeltaMELD/month, initial MELD and CP score.

RESULTS

Increased MELD score was associated with biochemical and clinical parameters such as esophageal variceal bleeding and onset of hepatic encephalopathy. The area under receiver operating characteristic (ROC) curve for DeltaMELD/month was 0.928 (P<0.001) compared with 0.575 for MELD score and 0.636 for CP score at 6 month-mortality; the area was 0.727, 0.594 and 0.657 at 12 month-mortality; 0.693, 0.587 and 0.639 at 24 month-mortality, respectively. The patients with DeltaMELD/month more than 1.0 had resulted in the higher mortality at 6, 12 and 24 months. The DeltaMELD/month was associated with mortality and was an independent prognostic predictor with a risk ratio of 1.679 (95% CI: 1.381-2.042, P<0.001).

CONCLUSIONS

Determination of DeltaMELD could be better prognostic predictor for patients with liver cirrhosis than initial MELD and CP score.

Authors+Show Affiliations

Institute for Digestive Research, Department of Internal Medicine, Soon Chun Hyang University, College of Medicine, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

kor

PubMed ID

17237631

Citation

Eun, Soo Hoon, et al. "[Clinical Usefulness of DeltaMELD to Predict the Survival of Patients With Liver Cirrhosis]." The Korean Journal of Hepatology, vol. 12, no. 4, 2006, pp. 530-8.
Eun SH, Kim YS, Jang JY, et al. [Clinical usefulness of DeltaMELD to predict the survival of patients with liver cirrhosis]. Korean J Hepatol. 2006;12(4):530-8.
Eun, S. H., Kim, Y. S., Jang, J. Y., Cheon, Y. G., Kim, Y. S., Cho, Y. D., Lee, J. S., Lee, M. S., Kim, J. H., Shim, C. S., & Kim, B. S. (2006). [Clinical usefulness of DeltaMELD to predict the survival of patients with liver cirrhosis]. The Korean Journal of Hepatology, 12(4), 530-8.
Eun SH, et al. [Clinical Usefulness of DeltaMELD to Predict the Survival of Patients With Liver Cirrhosis]. Korean J Hepatol. 2006;12(4):530-8. PubMed PMID: 17237631.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Clinical usefulness of DeltaMELD to predict the survival of patients with liver cirrhosis]. AU - Eun,Soo Hoon, AU - Kim,Yun Soo, AU - Jang,Jae Young, AU - Cheon,Young Gook, AU - Kim,Young Seok, AU - Cho,Young Deok, AU - Lee,Joon Sung, AU - Lee,Moon Sung, AU - Kim,Ju Hyun, AU - Shim,Chan Sup, AU - Kim,Boo Sung, PY - 2007/1/24/pubmed PY - 2008/9/10/medline PY - 2007/1/24/entrez SP - 530 EP - 8 JF - The Korean journal of hepatology JO - Korean J Hepatol VL - 12 IS - 4 N2 - BACKGROUNDS/AIMS: The change of MELD (Model for End-stage Liver Disease) score over time (DeltaMELD) has been proposed as a tool to predict the survival in cirrhotic patients. The aims of the study were to assess ability of the DeltaMELD to predict the survival and compare them with the initial MELD and CP score. METHODS: MELD score was serially determined at least twice with more than two-month interval in 120 cirrhotic patients. We analyzed the clinical factors associated with the variation of MELD score. The predictive power of 6, 12 and 24 months mortality for DeltaMELD, initial MELD and CP score was compared by c-statistics. Patient survival was also compared at 6, 12 and 24 months according to the cut off values of DeltaMELD/month, initial MELD and CP score. RESULTS: Increased MELD score was associated with biochemical and clinical parameters such as esophageal variceal bleeding and onset of hepatic encephalopathy. The area under receiver operating characteristic (ROC) curve for DeltaMELD/month was 0.928 (P<0.001) compared with 0.575 for MELD score and 0.636 for CP score at 6 month-mortality; the area was 0.727, 0.594 and 0.657 at 12 month-mortality; 0.693, 0.587 and 0.639 at 24 month-mortality, respectively. The patients with DeltaMELD/month more than 1.0 had resulted in the higher mortality at 6, 12 and 24 months. The DeltaMELD/month was associated with mortality and was an independent prognostic predictor with a risk ratio of 1.679 (95% CI: 1.381-2.042, P<0.001). CONCLUSIONS: Determination of DeltaMELD could be better prognostic predictor for patients with liver cirrhosis than initial MELD and CP score. SN - 1738-222X UR - https://www.unboundmedicine.com/medline/citation/17237631/[Clinical_usefulness_of_DeltaMELD_to_predict_the_survival_of_patients_with_liver_cirrhosis]_ L2 - https://medlineplus.gov/cirrhosis.html DB - PRIME DP - Unbound Medicine ER -