Analysis of mortality prognostic factors using model for end-stage liver disease with incorporation of serum-sodium classification for liver cirrhosis complications

Abstract

Since the progression of cirrhosis is accelerated each time a complication recurs, the management and treatment of the complication is critical in enhancement of the quality of life and expectation of life in patients. The use of model for end-stage liver disease with incorporation of serum-sodium (MELD-Na) with physiological indicators can be used to assess severity and differentiate therapeutic interventions.This study is aimed to determine the mean survival period and cumulative survival rate by classifying patients into high-risk and lowrisk groups based on MELD-Na, a predictor of mortality in liver disease, and to investigate the mortality prognostic factors.A retrospective cohort study, which follows the STROBE checklist, was performed. 263 patients who were diagnosed with liver cirrhosis complications for the first time and hospitalized were selected as the subjects of this study. The collected data were analyzed based on the survival package provided by the statistical program R version 3.4.2.Subjects were classified into high-risk and low-risk groups using MELD-Na 14 points where sensitivity and specificity crossed the cut-off point. Gender, age, and primary caregiver were significant variables in the mortality high-risk group, and AST, albumin, and primary caregiver were significant variables in the mortality low-risk group. Based on these mortality prognostic factors, it is possible to present the factors affecting mortality in patients who were diagnosed with liver cirrhosis complications for the first time. The classification of patients by risk level could be the foundation to provide accurate guidelines for management and it is necessary to modify prognostic factors and apply nursing interventions to manage complications.Abbreviations: AST = aspartate transferase, MELD-Na = model for end-stage liver disease with incorporation of serum-sodium.

Predictive Factors for the Prognosis of Alcoholic Liver Cirrhosis

“…We obtained a cut-off value of 17 for the MELD-Na score, relatively lower than that reported in other studies [32,33]. While most specialists focused on patients with end-stage alcoholic cirrhosis or hospitalized in an intensive care unit and scheduled for liver transplantation, we evaluated all cirrhotic subjects, regardless of the severity of the disease [33][34][35].…”

Clinical Presentation and Outcome in Hospitalized Patient With Decompensated Cirrhosis of Liver in a Tertiary Care Centre of Nepal

“…3 Liver cirrhosis is a major health problem worldwide and is associated with increased morbidity and overall5, 10, and 15year survival rates of only 68%, 57%, and 43%, respectively. 4 Liver cirrhosis is a common disease in Nepal, mainly because of low literacy rate, lack of awareness and easy accessibility and very common use of alcohol. 5,6 Few available National data and studies on decompensated cirrhosis in hospitalized patients showed worse outcome compared to developed countries.…”

A Review of Mortality Risk Prediction Models in Smartphone Applications

“…In intensive care units (ICU), healthcare professionals use mortality prediction models (MPMs) to triage patients [2][3][4], quantify the risk of sepsis and death [5,6], and to estimate the cost of medical treatment [7][8][9]. MPMs are also used to prognosticate weaning from ventilators, length of ICU stay, mortality, and rate of recovery [10][11][12][13][14][15]. The MPM algorithms use physiologic measures [16] within 24 h of admission into the ICU [17] to calculate a risk score [18,19].…”