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[Usefulness of DeltaMELD/month for prediction of the mortality in the first episode of variceal bleeding patients with liver cirrhosis: comparison with CTP, MELD score and DeltaCTP/month].
Korean J Hepatol. 2007 Mar; 13(1):51-60.KJ

Abstract

BACKGROUND AND AIMS

There are many models for predicting prognosis of liver cirrhosis including Child Turcotte Pugh (CTP), the model for end-stage liver disease (MELD) score and its changes over time (DeltaCTP and DeltaMELD/month). We investigated the ability of these models to predict the mortality of liver cirrhosis patients with the first episode of variceal bleeding and which model can be usefully applied in practice.

METHODS

Seventy-one liver cirrhosis patients hospitalized for the first episode of esophageal variceal bleeding were retrospectively analyzed. The predictive power of initial CTP, MELD score, DeltaCTP and DeltaMELD/month was compared through c-statistics and multiple logistic regression.

RESULTS

All of the prognostic predictors measured higher in patients who survived than in those who died. The area under the receiver operating characteristic (ROC) curve for DeltaMELD/month in 6 months was 1, a higher value than 0.81 for initial CTP, 0.75 for initial MELD, and 0.84 for DeltaCTP/month; the area of DeltaMELD/month in 12 months was 0.81, also showing a higher value than others. DeltaMELD/month >0.27 was a strong significant prognostic predictor in 6 (odds ratio: 40.1, p=0.001) and 12 months (odds ratio: 14.1, p<0.001). Only the DeltaMELD/month was an independent prognostic predictor with a risk ratio of 1.604 (95% CI: 1.119-2.302, p=0.01) in 6 months and 1.627 (95% CI: 1.294-2.047, p<0.001) in 12 months.

CONCLUSIONS

The DeltaMELD/month is superior to initial CTP, MELD and DeltaCTP/month to predict 6 and 12 months mortality in liver cirrhosis patients with the first episode of variceal bleeding.

Authors+Show Affiliations

Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.No 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

17380075

Citation

Bae, Won Ki, et al. "[Usefulness of DeltaMELD/month for Prediction of the Mortality in the First Episode of Variceal Bleeding Patients With Liver Cirrhosis: Comparison With CTP, MELD Score and DeltaCTP/month]." The Korean Journal of Hepatology, vol. 13, no. 1, 2007, pp. 51-60.
Bae WK, Lee JS, Kim NH, et al. [Usefulness of DeltaMELD/month for prediction of the mortality in the first episode of variceal bleeding patients with liver cirrhosis: comparison with CTP, MELD score and DeltaCTP/month]. Korean J Hepatol. 2007;13(1):51-60.
Bae, W. K., Lee, J. S., Kim, N. H., Kim, K. A., Moon, Y. S., & Oh, M. K. (2007). [Usefulness of DeltaMELD/month for prediction of the mortality in the first episode of variceal bleeding patients with liver cirrhosis: comparison with CTP, MELD score and DeltaCTP/month]. The Korean Journal of Hepatology, 13(1), 51-60.
Bae WK, et al. [Usefulness of DeltaMELD/month for Prediction of the Mortality in the First Episode of Variceal Bleeding Patients With Liver Cirrhosis: Comparison With CTP, MELD Score and DeltaCTP/month]. Korean J Hepatol. 2007;13(1):51-60. PubMed PMID: 17380075.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Usefulness of DeltaMELD/month for prediction of the mortality in the first episode of variceal bleeding patients with liver cirrhosis: comparison with CTP, MELD score and DeltaCTP/month]. AU - Bae,Won Ki, AU - Lee,June Sung, AU - Kim,Nam Hoon, AU - Kim,Kyung Ah, AU - Moon,Young Soo, AU - Oh,Min Kyung, PY - 2007/3/24/pubmed PY - 2008/9/9/medline PY - 2007/3/24/entrez SP - 51 EP - 60 JF - The Korean journal of hepatology JO - Korean J Hepatol VL - 13 IS - 1 N2 - BACKGROUND AND AIMS: There are many models for predicting prognosis of liver cirrhosis including Child Turcotte Pugh (CTP), the model for end-stage liver disease (MELD) score and its changes over time (DeltaCTP and DeltaMELD/month). We investigated the ability of these models to predict the mortality of liver cirrhosis patients with the first episode of variceal bleeding and which model can be usefully applied in practice. METHODS: Seventy-one liver cirrhosis patients hospitalized for the first episode of esophageal variceal bleeding were retrospectively analyzed. The predictive power of initial CTP, MELD score, DeltaCTP and DeltaMELD/month was compared through c-statistics and multiple logistic regression. RESULTS: All of the prognostic predictors measured higher in patients who survived than in those who died. The area under the receiver operating characteristic (ROC) curve for DeltaMELD/month in 6 months was 1, a higher value than 0.81 for initial CTP, 0.75 for initial MELD, and 0.84 for DeltaCTP/month; the area of DeltaMELD/month in 12 months was 0.81, also showing a higher value than others. DeltaMELD/month >0.27 was a strong significant prognostic predictor in 6 (odds ratio: 40.1, p=0.001) and 12 months (odds ratio: 14.1, p<0.001). Only the DeltaMELD/month was an independent prognostic predictor with a risk ratio of 1.604 (95% CI: 1.119-2.302, p=0.01) in 6 months and 1.627 (95% CI: 1.294-2.047, p<0.001) in 12 months. CONCLUSIONS: The DeltaMELD/month is superior to initial CTP, MELD and DeltaCTP/month to predict 6 and 12 months mortality in liver cirrhosis patients with the first episode of variceal bleeding. SN - 1738-222X UR - https://www.unboundmedicine.com/medline/citation/17380075/[Usefulness_of_DeltaMELD/month_for_prediction_of_the_mortality_in_the_first_episode_of_variceal_bleeding_patients_with_liver_cirrhosis:_comparison_with_CTP_MELD_score_and_DeltaCTP/month]_ L2 - https://medlineplus.gov/cirrhosis.html DB - PRIME DP - Unbound Medicine ER -