MELD scores with incorporation of serum sodium and death prediction in cirrhotic patients on the waiting list for liver transplantation: a single center experience in southern Brazil
| Autor: | Caroline Possa, Marroni, Ajácio Bandeira, de Mello Brandão, Alexandre Wahl, Hennigen, Claudio, Marroni, Maria Lúcia, Zanotelli, Guido, Cantisani, Sandra Costa, Fuchs, Mário Henrique, de Mattos Meine |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Time Factors Adolescent Waiting Lists medicine.medical_treatment Liver transplantation Single Center Gastroenterology Risk Assessment Severity of Illness Index Cohort Studies End Stage Liver Disease Tertiary Care Centers Liver disease Young Adult Model for End-Stage Liver Disease Internal medicine Severity of illness medicine Health Status Indicators Humans Survival rate Transplantation Receiver operating characteristic business.industry Sodium Middle Aged Models Theoretical medicine.disease Prognosis Surgery Liver Transplantation body regions Survival Rate Area Under Curve Disease Progression Female business Brazil Cohort study Follow-Up Studies |
| Zdroj: | Clinical transplantation. 26(4) |
| ISSN: | 1399-0012 |
| Popis: | To compare the accuracy of standard model for end-stage liver disease (MELD) score with that of four MELD-based scores incorporating serum sodium (SNa) to predict three- and six-month mortality in cirrhotic patients after their placement on the waiting list for liver transplantation (LT). A cohort study was performed. Receiver operating characteristic (ROC) curves were generated for MELD, MELD incorporating SNa (MELD-Na, MELD-Na2), integrated MELD (iMELD), and MELD to SNa ratio (MESO) index to assess the predictive accuracy of these scores to determine three- and six-month mortality. The c-statistic (area under the ROC curve [AUC]) was used to determine predictive power and the Cox proportional-hazard ratio to estimate death risk. We studied 558 patients. There was a statistically significant difference in the predictive accuracy of scores at three months (AUCs: MELD = 0.79 [95% CI = 0.72-0.87]; MELD-Na = 0.84 [95% CI = 0.78-0.90]; MELD-Na2 = 0.85 [95% CI = 0.80-0.91]; iMELD = 0.85 [95% CI = 0.80-0.90]; MESO = 0.81 [95% CI = 0.80-0.91]) and at six months (MELD = 0.73 [95% CI = 0.67-0.80]; MELD-Na = 0.79 [95% CI = 0.73-0.84]; MELD-Na2 = 0.80 [95% CI = 0.74-0.85]; iMELD = 0.80 [95% CI = 0.75-0.85]; MESO = 0.75 [95% CI = 0.69-0.81]) (p < 0.001). Death risk was independent of age and sex. Sodium-modified MELD scores are able to more accurately predict three- and six-month mortality among cirrhotic patients awaiting LT. |
| Databáze: | OpenAIRE |
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