The performance of prognostic models as predictors of mortality in patients with acute decompensation of cirrhosis

Fayad, Leonardo; Narciso-Schiavon, Janaína Luz; Lazzarotto, César; Ronsoni, Marcelo Fernando; Wildner, Letícia Muraro; Bazzo, Maria Luiza; Schiavon, Leonardo de Lucca; Dantas-Corrêa, Esther Buzaglo

doi:10.1016/s1665-2681(19)30804-x

Cited by 15 publications

(16 citation statements)

References 45 publications

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“…In our study, there were 153 patients, in which the number of male patients was double that of female patients (66.7%; 33.3%). This finding is consistent with the previous studies in Vietnam [19,20] and others worldwide [21][22][23][24]. Thus, the male predominance is apparent, especially in developing countries.…”

Section: General Patient Characteristicssupporting

confidence: 93%

“…In this study, the distribution of Child-Pugh scores was Child A (9.8%), Child B (44.4%), and Child C (45.8%.) Meanwhile, these proportions in Charif's study were Child A (19.2%), Child B (54.6%), and Child C (26.1%) [30] and, in Fayad's study, were Child A (12.2%), Child B (35.8%), and Child C (52%) [24]. This shows a marked difference in the distribution across Child classifications, especially for Child B and C. The mean values of MELD and MELDNa scores and LMR in our study were similar to the findings by other authors [19,25,36].…”

Section: Correlation Between Lmr and The Child-pugh And The Meld/meld...mentioning

confidence: 80%

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Correlation between the Lymphocyte-To-Monocyte Ratio (LMR) and Child–Pugh and MELD/MELDNa Scores in Vietnamese Patients with Liver Cirrhosis

Nguyen

Kha

Thai

et al. 2022

Gastroenterology Insights

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Objectives: This study aims to determine cirrhotic patients’ clinical and laboratory characteristics, thereby examining the correlation between lymphocyte-to-monocyte ratio and Child–Pugh and MELD/MELDNa scores. Methods: A cross-sectional study with an analysis of 153 patients admitted to the Department of Gastroenterology–Clinical Hematology at Can Tho Central General Hospital. Data were collected via patient interviews and medical records. Results: The included patients were more likely to be male (66.7%) and were ≥60 years old (51.6%). Excessive alcohol consumption and hepatitis B were the dominant causes of cirrhosis (35.3% and 34.0%). The clinical and laboratory characteristics were similar to previous studies in cirrhotic patients. The mean Child score was 9.3 ± 2.1, including 9.8% of patients with Child A, 44.4% for Child B, and 45.8% for Child C. The mean MELD and MELDNa scores were 16.9 ± 7.1 and 19.4 ± 8.1, respectively. The mean lymphocyte-to-monocyte ratio (LMR) is 2.0 ± 2.2 (from 0.09 to 25.3), being negatively correlated with the other scores (Pearson correlation coefficients were −0.238; −0.211 and −0.245, respectively, all p-values < 0.01). Patients with LMR below 3.31 were more likely to be classified as Child–Pugh B and C. Conclusion: The correlation between LMR with Child–Pugh, MELD, and MELDNa scores was weak and negative.

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Section: General Patient Characteristicssupporting

confidence: 93%

Section: Correlation Between Lmr and The Child-pugh And The Meld/meld...mentioning

confidence: 80%

Correlation between the Lymphocyte-To-Monocyte Ratio (LMR) and Child–Pugh and MELD/MELDNa Scores in Vietnamese Patients with Liver Cirrhosis

Nguyen

Kha

Thai

et al. 2022

Gastroenterology Insights

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“…The MELD score, which was initially formulated to assess the short-term prognosis of cirrhotic patients undergoing the transjugular intrahepatic portosystemic shunt [ 8 ], is now widely accepted as a high-potency prognostic scoring system for assessing short-term mortality in a broad spectrum of liver diseases [ 19 – 21 ], and its dramatic increase over time has also been demonstrated the ability to predict a poor outcome in ACLF patients [ 22 – 24 ]. However, the use of MELD score alone would underestimate the illness severity and mortality of ACLF patients with hemodynamic derangement, because the MELD score does not contain the assessment of abnormal hemodynamic states which are commonly found in ACLF patients [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Current Diagnostic Criteria for Acute-On-Chronic Liver Failure

et al. 2015

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Background and AimsCurrently, acute-on-chronic liver failure (ACLF) has been defined differently by Asia–Pacific Association for the Study of the Liver (APASL) and Chinese Medical Association (CMA) in the East, as well as EASL-Chronic Liver Failure (EASL-CLIF) Consortium in the West. This study aimed to compare current different diagnostic criteria for ACLF and to determine predictors of the progression into post-enrollment EASL-CLIF ACLF from ACLF at enrollment defined by APASL alone or by both APASL and CMA but not by EASL-CLIF Consortium.MethodsWe retrospectively analyzed clinical data from 394 eligible cirrhotic patients fulfilling at least APASL criteria for ACLF at enrollment. Patient survival was estimated by Kaplan-Meier analysis and subsequently compared by log-rank test. Independent predictors of disease progression were determined using univariate analysis and multivariate Cox regression analysis.ResultsThe 90-day mortality rate was 13.1% in patients with ACLF at enrollment defined by APASL alone, 25.3% in patients with ACLF at enrollment defined by both APASL and CMA but not EASL-CLIF Consortium, and 59.3% in patients with ACLF at enrollment defined by EASL-CLIF Consortium in addition to APASL. Baseline Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) score, and the maximum rising rates of CLIF-SOFA score, Model for End-Stage Liver Disease-Sodium (MELD-Na) score and total bilirubin were independent predictors of progression into post-enrollment EASL-CLIF ACLF from ACLF at enrollment defined by APASL alone or by both APASL and CMA but not by EASL-CLIF Consortium.ConclusionDifferent diagnostic criteria for ACLF caused different patient prognosis. So, it is imperative to formulate a unifying diagnostic criteria for ACLF worldwide, thus attaining early identification and treatment, and eventual improvement in survival of ACLF patients. Baseline CLIF-SOFA score, and the maximum rising rates of CLIF-SOFA score, MELD-Na score and total bilirubin may early predict post-enrollment development of EASL-CLIF ACLF.

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“…The diagnostic performance of an elevated HAv was studied using threshold values ranging from 70 160 cm/s (Table ). Using a threshold of MELD greater than 19, shown to be a helpful cut‐off for the prediction of mortality in high‐risk patients with liver cirrhosis, a HAv threshold of greater than 120 cm/s showed highest accuracy with greatest sensitivity, but a HAv threshold of greater than160 cm/s had the greatest odds ratio of 42.1. Sensitivity, specificity, PPV, and NPV for a threshold of greater than 120 cm/s were 42, 90, 67 and 76%, respectively; and 23, 99, 94 and 73%, respectively, for a threshold of greater than 160 cm/s.…”

Section: Resultsmentioning

confidence: 99%

Doppler Ultrasound in Liver Cirrhosis: Correlation of Hepatic Artery and Portal Vein Measurements With Model for End-Stage Liver Disease Score

et al. 2016

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The performance of prognostic models as predictors of mortality in patients with acute decompensation of cirrhosis

Cited by 15 publications

References 45 publications

Correlation between the Lymphocyte-To-Monocyte Ratio (LMR) and Child–Pugh and MELD/MELDNa Scores in Vietnamese Patients with Liver Cirrhosis

Correlation between the Lymphocyte-To-Monocyte Ratio (LMR) and Child–Pugh and MELD/MELDNa Scores in Vietnamese Patients with Liver Cirrhosis

Comparison of Current Diagnostic Criteria for Acute-On-Chronic Liver Failure

Doppler Ultrasound in Liver Cirrhosis: Correlation of Hepatic Artery and Portal Vein Measurements With Model for End-Stage Liver Disease Score

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