Accuracy of MELD Scores in Predicting Mortality in Decompensated Cirrhosis from Variceal Bleeding, Hepatorenal Syndrome, Alcoholic Hepatitis, or Acute Liver Failure As Well As Mortality After Non-transplant Surgery or TIPS

Sibae, Mohamad Rasm Al; Cappell, Mitchell S.

doi:10.1007/s10620-010-1390-3

Cited by 68 publications

(55 citation statements)

References 88 publications

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“…Furthermore, the Child-Pugh classification does not recognize a TBIL level >51 µmol/l. Additionally, ALB levels tend to be low immediately subsequent to bleeding or transfusions (29). The MELD scoring system was developed by the Mayo Clinic team, and was originally used to predict the prognosis of portal hypertension patients following transjugular intrahepatic portosystemic shunt (27).…”

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confidence: 99%

Prognostic performance of clinical indices and model scorings for acute-on-chronic liver failure: A study of 164 patients

Zhang

Guo

Zhao

et al. 2016

Experimental and Therapeutic Medicine

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Abstract.The present study aimed to analyze the prognostic factors of acute-on-chronic liver failure (ACLF), with the perspective of an improved selection of optimal therapeutic schemes. A retrospective analysis was used to study 164 patients with ACLF hospitalized between 2010 and 2014 in a single center. Patients were divided into favorable and unfavorable groups, according to the treatment outcomes. General characteristics and clinical manifestations were analyzed to determine whether they would affect the prognosis of the patients with ACLF, with a particular focus on the scoring systems Child-Pugh, model for end-stage liver disease (MELD), MELD with incorporation of sodium (MELD-Na), MELD and serum sodium ratio (MESO) and integrated MELD (iMELD). Hepatitis B virus infection was the predominant cause of ACLF, accounting for 88 cases (53.7%). Age, prothrombin time, thrombin time, international normalized ratio (INR), prothrombin activity, serum sodium, albumin, total bilirubin, serum creatinine, platelets, fasting blood sugar, infections, hepatic encephalopathy, hepatorenal syndrome (HRS), and electrolyte disorder were revealed to be associated with prognosis. Age, serum sodium, INR, HRS, and infection were independent prognostic risk factors, as determined by multivariate analysis. Child-Pugh, MELD, MELD-Na, MESO and iMELD scoring systems all demonstrated adequate predictive values, with MELD-Na as the most effective scoring system. In conclusion, age, hyponatremia, INR, HRS and bacterial or fungal infections were reported to be independent prognostic risk factors for ACLF. Among the various liver function scoring systems, MELD-Na was the most accurate in predicting the prognosis of ACLF.

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Section: % CI Of or -----------------------------------------------mentioning

confidence: 99%

Prognostic performance of clinical indices and model scorings for acute-on-chronic liver failure: A study of 164 patients

Zhang

Guo

Zhao

et al. 2016

Experimental and Therapeutic Medicine

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“…Incorporation of additional parameters, including serum sodium level, serum albumin level, glucose intolerance, or APACHE II score, may potentially improve the prognostic accuracy. 10 The MELD score does not correlate well with severity of hepatic encephalopathy or ascites because approximately 90% of patients with clinical hepatic encephalopathy or abnormal EEG and neuropsychometric tests had a MELD score less than 25. 11 Biochemical tests for the assessment of liver function (commonly referred to as liver function tests) includes measurement of serum aspartate and alanine transaminases, serum bilirubin, serum albumin, serum protein and alkaline phosphatase, but these tests are often abnormal in patients with clinical problems other than liver dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Assessment of serum level cholinesterase as a biomarker of liver cirrhosis in Egyptian cirrhotic patients

Amin

El-Shahat

El-Garem

et al. 2017

Gastroenterol Insights

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“…However, the MELD score also became useful for predicting mortality in cirrhotic patients scheduled for nontransplantation-related surgical procedures, and in predicting mortality of patients with acute alcoholic hepatitis as well as other liver failure. 13 In colorectal surgery, MELD has gained increasing acceptance becoming the most commonly used method of outcomes determination.…”

Section: Discussionmentioning

confidence: 99%

Should We Use the Model for End-Stage Liver Disease (MELD) to Predict Mortality After Colorectal Surgery?

Pantel

Stensland

Nelson

et al. 2016

Journal of Gastrointestinal Surgery

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We sought to determine the accuracy of the Model for End-Stage Liver Disease and the Mayo Clinic Postoperative Mortality Risk in Patients with Cirrhosis Calculator in patients with ascites who underwent colorectal surgery. The National Surgical Quality Improvement Program database was queried for patients with ascites who underwent a major colorectal operation. Predicted 90-day mortality rate based on the Model for End-Stage Liver Disease and 30-day mortality based on the Mayo Clinic Postoperative Mortality Risk in Patients with Cirrhosis Calculator were compared with observed 30-day mortality. The cohort contained 3137 patients with ascites who underwent a colorectal operation. The Model for End-Stage Liver Disease predicted that 252 (8 %) of patients with ascites undergoing colorectal operations would die within 90 days postoperatively, yet we observed 821 deaths (26 % mortality) within 30 days after surgery (p < 0.001). The Mayo Clinic Postoperative Mortality Risk in Patients with Cirrhosis Calculator predicted that 491 (16.6 % mortality) of patients with ascites undergoing colorectal operations would die within 30 days postoperatively, yet we observed 707 (23.9 % mortality) at 30 days (p < 0.01). We concluded that the current risk prediction models significantly under predict mortality in patients with ascites who underwent colorectal surgery.

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Accuracy of MELD Scores in Predicting Mortality in Decompensated Cirrhosis from Variceal Bleeding, Hepatorenal Syndrome, Alcoholic Hepatitis, or Acute Liver Failure As Well As Mortality After Non-transplant Surgery or TIPS

Cited by 68 publications

References 88 publications

Prognostic performance of clinical indices and model scorings for acute-on-chronic liver failure: A study of 164 patients

Prognostic performance of clinical indices and model scorings for acute-on-chronic liver failure: A study of 164 patients

Assessment of serum level cholinesterase as a biomarker of liver cirrhosis in Egyptian cirrhotic patients

Should We Use the Model for End-Stage Liver Disease (MELD) to Predict Mortality After Colorectal Surgery?

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