Applicability of MELD as a short‐term prognostic indicator in patients with chronic liver disease: An Indian experience

Mishra, Peeyush; Desai, Nutan; Alexander, Jacob; Singh, Dharmendra; Sawant, Prabha

doi:10.1111/j.1440-1746.2007.04903.x

Cited by 17 publications

(13 citation statements)

References 24 publications

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“…This study shows that in both the CTP classification and the MELD scoring system, a poor prognosis was associated with higher preoperative cytokine concentrations, which suggests that both rating systems are useful for predicting the severity of the systemic inflammatory response in patients with end-stage liver disease. This result is consistent with those of Boin et al (2), Said et al (5), and Mishra et al (20), who suggested that both the CTP classification system and the MELD scores were equivalent for determining the outcome of patients suffering from chronic liver disease.…”

Section: Discussionsupporting

confidence: 92%

Comparison of the Child-Turcotte-Pugh Classification and the Model for End-stage Liver Disease Score as Predictors of the Severity of the Systemic Inflammatory Response in Patients Undergoing Living-donor Liver Transplantation

et al. 2011

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The aim of this study was to evaluate and compare the Child-Turcotte-Pugh (CTP) classification system and the model for end-stage liver disease (MELD) score in predicting the severity of the systemic inflammatory response in living-donor liver transplantation patients. Recipients of liver graft were allocated to a recipient group (n = 39) and healthy donors to a donor group (n = 42). The association between the CTP classification, the MELD scores and perioperative cytokine concentrations in the recipient group was evaluated. The pro-inflammatory cytokines measured included interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α; the anti-inflammatory cytokines measured included IL-10 and IL-4. Cytokine concentrations were quantified using sandwich enzyme-linked immunoassays. The IL-6, TNF-α, and IL-10 concentrations in the recipient group were significantly higher than those in healthy donor group patients. All preoperative cytokine levels, except IL-6, increased in relation to the severity of liver disease, as measured by the CTP classification. Additionally, all cytokine levels, except IL-6, were significantly correlated preoperatively with MELD scores. However, the correlations diminished during the intraoperative period. The CTP classification and the MELD score are equally reliable in predicting the severity of the systemic inflammatory response, but only during the preoperative period.

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Section: Discussionsupporting

confidence: 92%

Comparison of the Child-Turcotte-Pugh Classification and the Model for End-stage Liver Disease Score as Predictors of the Severity of the Systemic Inflammatory Response in Patients Undergoing Living-donor Liver Transplantation

et al. 2011

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“…The MELD has been demonstrated to have a better ability in short‐term and intermediate‐term outcome prediction in comparison with the Child–Pugh score (14, 15). Nonetheless, the MELD still has potential limitations (16, 17). Hepatic encephalopathy, oesophageal varices bleeding and SBP are common complications associated with cirrhosis, which had been considered one of the allocation policies of liver providing.…”

Section: Discussionmentioning

confidence: 99%

Outcome predictors of cirrhotic patients with spontaneous bacterial empyema

Chen¹,

Shih²,

Chou³

et al. 2011

Liver International

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“…MELD has been demonstrated to have a better ability in short-term or intermediate-term outcome prediction in comparison with the Child-Turcotte-Pugh (CTP) system [15][16][17] . Nonetheless, MELD still has potential limitations [18][19][20][21] . Hepatic encephalopathy, esophageal varices bleeding and spontaneous bacterial peritonitis are common complications with cirrhosis, which had been considered one of the allocation policies of liver providing.…”

Section: Discussionmentioning

confidence: 99%

Evolution of systemic therapy of advanced hepatocellular carcinoma

Jiang

Liu²,

Xiong³

et al. 2008

WJG

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year, the iMELD still had the highest AUC (0.783), the difference between the iMELD and MELD was statistically significant (P < 0.05). Survival curves showed that the three new models were all clearly discriminated the patients who survived or died in short-term as well as intermediate-term (P < 0.001 INTRODUCTIONThe model for end-stage liver disease (MELD) was developed as a prognostic model of short-term mortality in patients with cirrhosis treated with transjugular intrahepatic portosystemic shunt (TIPS) [1] . The scoring system has been widely applied in recent years and shown to predict mortality across a broad spectrum of liver diseases in most studies. But, there is not any parameter correlated with complications of cirrhosis in this formula. Its ability of prognosis is decreased. Some studies have indicated that serum sodium is the independent predictor of mortality in patients with cirrhosis [2,3] . And the incorporation of Na into the MELD may enhance its prognostic accuracy [4,5] . Then some scholars had successively introduced three new mathematical equations based on both MELD and Na, Abstract AIM: To investigate the prognostic value of the model for end-stage liver disease (MELD) and three new MELD-based models combination with serum sodium in decompensated cirrhosis patients-the MELD with the incorporation of serum sodium (MELD-Na), the integrated MELD (iMELD), and the MELD to sodium (MESO) index. METHODS: A total of 166 patients with decompensated cirrhosis were enrolled into the study. MELD, MELDNa, iMELD and MESO scores were calculated for each patient following the original formula on the first day of admission. All patients were followed up at least 1 year. The predictive prognosis related with the four models was determined by the area under the receiver operating characteristic curve (AUC) of the four parameters. Kaplan-Meier survival curves were made using the cut-offs identified by means of receiver operating characteristic (ROC). RESULTS: Out of 166 patients, 38 patients with significantly higher MELD-Na (28.84 ± 2.43 vs 14.72 ± 0.60), iMELD (49.04 ± 1.72 vs 35.52 ± 0.67), MESO scores (1.59 ± 0.82 vs 0.99 ± 0.42) compared to the survivors died within 3 mo (P < 0.001). Of 166 patients, 75 with markedly higher MELD-Na (23.01 ± 1.51 vs 13.78 ± 0.69), iMELD (44.06 ± 1.19 vs 34.12 ± 0.69), MESO scores (1.37 ± 0.70 vs 0.93 ± 0.40) than the survivors died within 1 year (P < 0.001). At 3 mo of enrollment, the iMELD had the highest AUC (0.841), and was followed by the MELD-Na (0.766), MESO (0.723), all larger than MELD (0.773); At 1

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Applicability of MELD as a short‐term prognostic indicator in patients with chronic liver disease: An Indian experience

Abstract: The MELD score was not found to be superior to CTP score and modified CTP score for short-term prognostication of patients with cirrhosis in this study.

Cited by 17 publications

References 24 publications

Comparison of the Child-Turcotte-Pugh Classification and the Model for End-stage Liver Disease Score as Predictors of the Severity of the Systemic Inflammatory Response in Patients Undergoing Living-donor Liver Transplantation

Comparison of the Child-Turcotte-Pugh Classification and the Model for End-stage Liver Disease Score as Predictors of the Severity of the Systemic Inflammatory Response in Patients Undergoing Living-donor Liver Transplantation

Outcome predictors of cirrhotic patients with spontaneous bacterial empyema

Evolution of systemic therapy of advanced hepatocellular carcinoma

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