Validation of MELD 3.0 in patients with alcoholic liver cirrhosis using prospective KACLiF cohort.

Autor: Lim J; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Kim JH; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, Republic of Korea., Kim SE; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, Republic of Korea., Han SK; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea., Kim TH; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, Republic of Korea., Yim HJ; Division of Gastroenterology, Department of Internal Medicine, Korea University Medical Center, Seoul, Republic of Korea., Jung YK; Division of Gastroenterology, Department of Internal Medicine, Korea University Medical Center, Seoul, Republic of Korea., Song DS; Division of Gastroenterology and Hepatology Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Yoon EL; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea., Kim HY; Division of Gastroenterology and Hepatology Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Kang SH; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea., Chang Y; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Republic of Korea., Yoo JJ; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea., Lee SW; Division of Gastroenterology and Hepatology Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Park JG; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea., Park JW; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea., Jeong SW; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Republic of Korea., Suk KT; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, Republic of Korea., Kim MY; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea., Kim SG; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea., Kim W; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea., Jang JY; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Republic of Korea., Yang JM; Division of Gastroenterology and Hepatology Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Kim DJ; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, Republic of Korea.
Jazyk: angličtina
Zdroj: Journal of gastroenterology and hepatology [J Gastroenterol Hepatol] 2024 Sep; Vol. 39 (9), pp. 1932-1938. Date of Electronic Publication: 2024 May 08.
DOI: 10.1111/jgh.16591
Abstrakt: Background and Aim: The Model for End-Stage Liver Disease (MELD) is a reliable prognostic tool for short-term outcome prediction in patients with end-stage liver disease. MELD 3.0 was introduced to enhance the predictive accuracy. This study assessed the performance of MELD 3.0, in comparison to MELD and MELD-Na, in patients with alcoholic liver cirrhosis.
Methods: This multicenter prospective cohort study comprised patients with alcoholic cirrhosis admitted for acute deterioration of liver function in the Republic of Korea between 2015 and 2019. This study compared the predictive abilities of MELD, MELD-Na, and MELD 3.0, for 30-day and 90-day outcomes, specifically death or liver transplantation, and explored the factors influencing these outcomes.
Results: A total of 1096 patients were included in the study, with a mean age of 53.3 ± 10.4 years, and 82.0% were male. The mean scores for MELD, MELD-Na, and MELD 3.0 at the time of admission were 18.7 ± 7.2, 20.6 ± 7.7, and 21.0 ± 7.8, respectively. At 30 and 90 days, 7.2% and 14.1% of patients experienced mortality or liver transplantation. The areas under the receiver operating characteristic curves for MELD, MELD-Na, and MELD 3.0 at 30 days were 0.823, 0.820, and 0.828; and at 90 days were 0.765, 0.772, and 0.776, respectively. Factors associated with the 90-day outcome included concomitant chronic viral hepatitis, prolonged prothrombin time, elevated levels of aspartate transaminase, bilirubin, and creatinine, and low albumin levels.
Conclusion: MELD 3.0 demonstrated improved performance compared to previous models, although the differences were not statistically significant.
(© 2024 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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