Assessing the Prognostic Performance of the Child-Pugh, Model for End-Stage Liver Disease, and Albumin-Bilirubin Scores in Patients with Decompensated Cirrhosis: A Large Asian Cohort from Gastroenterology Department

Abstract

Background and Aim. Various methods, including the Child-Pugh score, the model for end-stage liver disease (MELD) score, the MELD combined with serum sodium concentration (MELD-Na) score, the integrated MELD (iMELD) score, and the albumin-bilirubin (ALBI) score, have been widely used for predicting the survival of decompensated cirrhosis (DeCi) patients. In this study, we defined and compared the prognostic value of these scores to predict mortality in DeCi patients. Methods. We performed a single-center, observational retrospective study and analyzed 456 DeCi patients who were hospitalized in the gastroenterology department. The biochemical examination results and demographic characteristics of the patients were obtained, and five scores were calculated upon admission after 24 hours. All patients were observed until death, loss to follow-up, or specific follow-up times (28 days, 90 days, and 6 months). A receiver operating characteristic (ROC) curve was used to evaluate the ability of these methods to predict mortality in DeCi patients. Results. At 28 days, 90 days, and 6 months, the cumulative number of deaths was 50 (11.0%), 76 (16.6%), and 91 (19.9%), respectively. The scores were significantly higher in nonsurviving patients than in surviving patients. All scores yielded viable values in predicting 28-day, 90-day, and 6-month prognoses for DeCi patients. The areas under the ROC curve (AUROCs) of the ALBI score were higher than those of the other scores, which were only over 0.700 at 28 days. The AUROC of the MELD score was higher than that of the other scores, including the MELD-Na and iMELD scores, at 90 days and 6 months. Conclusion. All five methods (Child-Pugh score, MELD score, MELD-Na score, iMELD score, and ALBI score) provided a reliable prediction of mortality for both the short-term and long-term prognosis of patients with DeCi. The ALBI score may be particularly useful for assessing short-term outcomes, whereas the MELD score may be particularly useful for assessing long-term outcomes.

Association Between Serum IL-6, IL-10, IL-12, and IL-23 Levels and Severity of Liver Cirrhosis

“…The diagnosis of liver cirrhosis was based on the result of transient elastography (TE, FibroScan, Echosens, France). Result ≥12.5kPa was considered liver cirrhosis ( 13 ). Subjects with malignancy, systemic infection, and chronic kidney disease were excluded from the study.…”

Predictors of Voriconazole Trough Concentrations in Patients with Child–Pugh Class C Cirrhosis: A Prospective Study

“…Patients with Child–Pugh class C (CP-C) cirrhosis, the most serious class of liver cirrhosis in the Child–Pugh classification [ 1 , 2 , 3 ], are at a high risk of invasive fungal infections (IFIs) [ 4 , 5 ]. IFIs in CP-C patients are probably caused by their immunocompromised state and the application of a large number of steroids and broad-spectrum antimicrobial agents, as well as invasive procedures [ 6 ].…”

An Ensemble Learning Approach for Enhanced Classification of Patients With Hepatitis and Cirrhosis

“…Among them, MELD [30] and Child-Pugh [31] and their recent improvements are the elective clinical tool in liver disease assessment. However, despite their widespread used, their accuracy is still debated [32]- [34], and also their relative effectiveness has not been sorted out yet, with the outcome of several comparative studies remaining controversial [35]. Being this a still unsettled issue is confirmed by the recent publication in the literature of proposal for further variants of the original scores [36]- [38].…”