Predictive value of Refit <scp>M</scp>odel for <scp>E</scp>nd‐<scp>S</scp>tage <scp>Li</scp>ver <scp>D</scp>isease, Refit <scp>M</scp>odel for <scp>E</scp>nd‐<scp>S</scp>tage <scp>Li</scp>ver <scp>D</scp>isease‐<scp>N</scp>a, and pre‐existing scoring system for 3‐month mortality in <scp>K</scp>orean patients with cirrhosis

Koo, Ja Kyung; Kim, Jeong H.; Choi, Yun Jung; Lee, Cho I; Yang, Jae Hyuk; Yoon, Hun‐Young; Choi, Hye Jin; Ko, Soon Young; Choe, Won Hyeok; Kwon, So Young; Lee, Chang Hong

doi:10.1111/jgh.12156

Cited by 14 publications

(10 citation statements)

References 32 publications

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“…However, we could not prove that Refit MELDNa is the most accurate method for mortality prediction 8. Our present research, which is performed on the basis of existing data, also demonstrated that Refit MELDNa is not better than Refit MELD as a predictor of 3-month mortality in patients with cirrhosis and ascites.…”

Section: Discussioncontrasting

confidence: 72%

“…First is the difference in etiology between Korea and the United States (US) as we have mentioned in our previous report 8. According to the research in the US by Leise et al7, underlying liver disease was most commonly caused by HCV infection (43%), followed by alcohol consumption (17%), whereas HBV infection and alcohol constituted approximately 84% of the causes in the present study.…”

Section: Discussionmentioning

confidence: 43%

“…Refit MELDNa, which combined Refit MELD and serum sodium concentration, was also demonstrated recently 7. Previously, we reported that Refit MELDNa was not superior to Refit MELD in predicting mortality rates 8. In continuation with our previous study, we examined the 3-month predictive mortality value of the Child-Pugh score, Refit MELD, and Refit MELDNa in patients with cirrhosis and ascites.…”

Section: Introductionmentioning

confidence: 60%

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The refit model for end-stage liver disease-Na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascites

Kim

Koo

et al. 2014

Clin Mol Hepatol

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Background/AimsThe modification of the Model for End-Stage Liver Disease (MELD) scoring system (Refit MELD) and the modification of MELD-Na (Refit MELDNa), which optimized the MELD coefficients, were published in 2011. We aimed to validate the superiority of the Refit MELDNa over the Refit MELD for the prediction of 3-month mortality in Korean patients with cirrhosis and ascites.MethodsWe reviewed the medical records of patients admitted with hepatic cirrhosis and ascites to the Konkuk University Hospital between January 2006 and December 2011. The Refit MELD and Refit MELDNa were compared using the predictive value of the 3-month mortality, as assessed by the Child-Pugh score.ResultsIn total, 530 patients were enrolled, 87 of whom died within 3 months. Alcohol was the most common etiology of their cirrhosis (n=271, 51.1%), and the most common cause of death was variceal bleeding (n=20, 23%). The areas under the receiver operating curve (AUROCs) for the Child-Pugh, Refit MELD, and Refit MELDNa scores were 0.754, 0.791, and 0.764 respectively; the corresponding values when the analysis was performed only in patients with persistent ascites (n=115) were 0.725, 0.804, and 0.796, respectively. The significant difference found among the Child-Pugh, Refit MELD, and Refit MELDNa scores was between the Child-Pugh score and Refit MELD in patients with persistent ascites (P=0.039).ConclusionsRefit MELD and Refit MELDNa exhibited good predictability for 3-month mortality in patients with cirrhosis and ascites. However, Refit MELDNa was not found to be a better predictor than Refit MELD, despite the known relationship between hyponatremia and mortality in cirrhotic patients with ascites.

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Section: Discussioncontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 43%

Section: Introductionmentioning

confidence: 60%

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The refit model for end-stage liver disease-Na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascites

Kim

Koo

et al. 2014

Clin Mol Hepatol

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“…47,48 MELD is objective, easy to measure, widely available, and supported by a very large body of evidence as a predictor for mortality risk over a 3-month period. 47,[49][50][51][52][53][54] Patients with NASH and compensated cirrhosis generally have low MELD scores, and the ability of low MELD scores to predict changes in mortality are not as robust as high MELD scores. However, subjects with a MELD score >10 are more likely to experience decompensation and a liver-related clinical outcome than those with lower scores.…”

Section: Endpoints Based On " Hard Clinical Outcomes"mentioning

confidence: 99%

Challenges and opportunities in drug and biomarker development for nonalcoholic steatohepatitis: Findings and recommendations from an American Association for the Study of Liver Diseases–U.S. Food and Drug Administration Joint Workshop

et al. 2015

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Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in North America. It is a growing contributor to the burden of chronic liver disease requiring liver transplantation. Cirrhosis is also associated with an increased risk of hepatocellular cancer which may occur even in the absence of cirrhosis in subjects with nonalcoholic steatohepatitis (NASH) the histological form of NAFLD associated with increased liver-related mortality. The diagnosis of NASH currently requires a liver biopsy. There are also no FDA-approved therapies for NASH. There is therefore a need to develop better diagnostic and therapeutic strategies for patients with NASH targeting both those with early stage disease as well as those with advanced liver fibrosis. There are unique challenges in the design of studies for these target populations. The long relatively asymptomatic time interval in the progression of NAFLD and NASH to cirrhosis and ultimately liver failure, along with gaps in knowledge regarding disease modifiers combine to present significant challenges in trial design. There is therefore an urgent need to develop methods to identify the populations at particular risk of disease progression and to validate endpoints that reflect meaningful changes in health status in this population. This manuscript summarizes the discussion at a joint workshop held September 5th and 6th, 2013, in Silver Spring, Maryland, sponsored by the FDA and the AASLD to develop guidance on diagnostic and therapeutic modalities for NASH.

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“…The MELD score incorporates 3 laboratory variables of TBil, international normalized ratio (INR) and creatinine, and eliminates the subjective factors . It helps evaluate the severity of liver cirrhosis caused by various factors, but it is specifically designed for patients with end‐stage cirrhosis …”

Section: Introductionmentioning

confidence: 99%

Usefulness of albumin‐bilirubin grade for evaluation of long‐term prognosis for hepatitis B‐related cirrhosis

Chen

Cai

et al. 2016

Journal of Viral Hepatitis

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Long-term prognosis varies widely among patients with hepatitis B virus (HBV)-related liver cirrhosis. Our study aimed to investigate the applicability of albumin-bilirubin (ALBI), Child-Pugh and model for end-stage liver disease (MELD) scores to the long-term prognosis prediction of HBV-related cirrhosis. Patients diagnosed with HBV-associated cirrhosis from the First Affiliated Hospital of Wenzhou Medical University between January 2010 and December 2015 were enrolled in this study. The patients were followed up every 3 months. The prognostic performance of ALBI in long-term outcome prediction for HBV-related cirrhosis was compared with Child-Pugh and MELD scores using time-dependent receiver operating characteristic curve (tdROC) and decision curve analysis. A total of 806 patients were included in our study with 275 (34.1%) deceased during the follow-up. Multivariate Cox regression analysis showed that ALBI grade was an independent predictor associated with mortality. The tdROC analysis showed that ALBI score (0.787, 0.830 and 0.833) was superior to MELD (0.693, P=.003; 0.717, P<.001; 0.744, P<.001) and Child-Pugh score (0.641, P<.001; 0.649, P<.001; 0.657, P<.001) for predicting 1-year, 2-year and 3-year mortality. Additionally, decision curves also got the similar results. In addition, patients with lower ALBI score had a longer life expectancy, even among patients within the same Child-Pugh class. Thus, ALBI score was effective in predicting the long-term prognosis for patients with HBV-related cirrhosis and more accurate than Child-Pugh and MELD scores.

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Predictive value of Refit Model for End‐Stage Liver Disease, Refit Model for End‐Stage Liver Disease‐Na, and pre‐existing scoring system for 3‐month mortality in Korean patients with cirrhosis

Abstract: The improvement in predictive value for 3-month mortality was not definite. The Refit MELD-Na especially showed the lowest value. This result may have been due to differences in underlying etiology of cirrhosis between Korea and the U.S. Thus, a larger prospective study is warranted.

Cited by 14 publications

References 32 publications

The refit model for end-stage liver disease-Na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascites

The refit model for end-stage liver disease-Na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascites

Challenges and opportunities in drug and biomarker development for nonalcoholic steatohepatitis: Findings and recommendations from an American Association for the Study of Liver Diseases–U.S. Food and Drug Administration Joint Workshop

Usefulness of albumin‐bilirubin grade for evaluation of long‐term prognosis for hepatitis B‐related cirrhosis

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