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Serum sodium and hydration status predict transplant-free survival independent of MELD score in patients with cirrhosis.
J Gastroenterol Hepatol. 2008 Feb; 23(2):239-43.JG

Abstract

BACKGROUND AND AIM

Serum sodium may have prognostic value in addition to the model for end-stage liver disease (MELD) score for prediction of early mortality in patients listed for liver transplant. In patients with cirrhosis, over-hydration is a common feature but its prognostic value has not been evaluated. This study examines the independent prognostic significance of MELD, serum sodium and hydration status on long-term survival in patients with cirrhosis.

METHODS

Serum sodium and hydration (total body water as a percentage of fat-free mass) were measured in 227 consecutive cirrhotic patients (146 male, 81 female; median age 49 years, range 19-73 years; median MELD score 13, range 6-36). Patients with hepatocellular carcinoma or listed for liver transplantation at the time of initial assessment were excluded. A competing risks Cox proportional hazards analysis was performed to evaluate the influence of MELD, sodium and hydration on risk of death or transplant.

RESULTS

Median follow-up was 52 (range 4-93) months. Serum sodium and hydration were each associated with reduction in time to death or transplant on univariate analysis (sodium: hazard ratio [HR] 0.90, 95% confidence interval [CI] 0.87-0.94, P < 0.0001; hydration: HR 1.20, 95% CI 1.10-1.30, P < 0.0001). On multivariate analysis, MELD, serum sodium and hydration were independently predictive of death or transplant (MELD: HR 1.12, 95% CI 1.06-1.19, P < 0.0001; sodium: HR 0.93, 95% CI 0.87-0.99, P = 0.04; hydration: HR 1.17, 95% CI 1.02-1.33, P = 0.02).

CONCLUSIONS

In non-waitlisted patients with cirrhosis, serum sodium is predictive of transplant or death independent of MELD score.

Authors+Show Affiliations

Department of Surgery, University of Auckland, Auckland, New Zealand.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17489965

Citation

Mathur, Sachin, et al. "Serum Sodium and Hydration Status Predict Transplant-free Survival Independent of MELD Score in Patients With Cirrhosis." Journal of Gastroenterology and Hepatology, vol. 23, no. 2, 2008, pp. 239-43.
Mathur S, Gane EJ, McCall JL, et al. Serum sodium and hydration status predict transplant-free survival independent of MELD score in patients with cirrhosis. J Gastroenterol Hepatol. 2008;23(2):239-43.
Mathur, S., Gane, E. J., McCall, J. L., & Plank, L. D. (2008). Serum sodium and hydration status predict transplant-free survival independent of MELD score in patients with cirrhosis. Journal of Gastroenterology and Hepatology, 23(2), 239-43.
Mathur S, et al. Serum Sodium and Hydration Status Predict Transplant-free Survival Independent of MELD Score in Patients With Cirrhosis. J Gastroenterol Hepatol. 2008;23(2):239-43. PubMed PMID: 17489965.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum sodium and hydration status predict transplant-free survival independent of MELD score in patients with cirrhosis. AU - Mathur,Sachin, AU - Gane,Edward J, AU - McCall,John L, AU - Plank,Lindsay D, Y1 - 2007/04/19/ PY - 2007/5/11/pubmed PY - 2008/4/4/medline PY - 2007/5/11/entrez SP - 239 EP - 43 JF - Journal of gastroenterology and hepatology JO - J. Gastroenterol. Hepatol. VL - 23 IS - 2 N2 - BACKGROUND AND AIM: Serum sodium may have prognostic value in addition to the model for end-stage liver disease (MELD) score for prediction of early mortality in patients listed for liver transplant. In patients with cirrhosis, over-hydration is a common feature but its prognostic value has not been evaluated. This study examines the independent prognostic significance of MELD, serum sodium and hydration status on long-term survival in patients with cirrhosis. METHODS: Serum sodium and hydration (total body water as a percentage of fat-free mass) were measured in 227 consecutive cirrhotic patients (146 male, 81 female; median age 49 years, range 19-73 years; median MELD score 13, range 6-36). Patients with hepatocellular carcinoma or listed for liver transplantation at the time of initial assessment were excluded. A competing risks Cox proportional hazards analysis was performed to evaluate the influence of MELD, sodium and hydration on risk of death or transplant. RESULTS: Median follow-up was 52 (range 4-93) months. Serum sodium and hydration were each associated with reduction in time to death or transplant on univariate analysis (sodium: hazard ratio [HR] 0.90, 95% confidence interval [CI] 0.87-0.94, P < 0.0001; hydration: HR 1.20, 95% CI 1.10-1.30, P < 0.0001). On multivariate analysis, MELD, serum sodium and hydration were independently predictive of death or transplant (MELD: HR 1.12, 95% CI 1.06-1.19, P < 0.0001; sodium: HR 0.93, 95% CI 0.87-0.99, P = 0.04; hydration: HR 1.17, 95% CI 1.02-1.33, P = 0.02). CONCLUSIONS: In non-waitlisted patients with cirrhosis, serum sodium is predictive of transplant or death independent of MELD score. SN - 1440-1746 UR - https://www.unboundmedicine.com/medline/citation/17489965/Serum_sodium_and_hydration_status_predict_transplant_free_survival_independent_of_MELD_score_in_patients_with_cirrhosis_ L2 - https://doi.org/10.1111/j.1440-1746.2007.04891.x DB - PRIME DP - Unbound Medicine ER -