Comparison Of MELD And MELD-based Models Combination With Serum Sodium In Evaluating The Prognosis Of Decompensated Cirrhosis

AimTo compare the predictive value of the model for end-stage liver disease (MELD) and MELD-based models combination with serum sodium (MELD-Na,MESO and iMELD) in decompensated cirrhosis.MethodsA cohort of 233 patients with decompensated cirrhosis were enrolled to have a retrospective studies in the study. These patients had complete case data and follow-up result. All patients were followed up for 1 year. MELD,MELD-Na,MESO and iMELD scores were calculated for each patient. The areas under the receicer operating characteristic curve (AUC) were calculated to compare the predictive value of these four models. Kaplan-Meier survival curves were made using the cut-offs which obtained from the receiver operating characteristic (ROC).ResultsIn 233 patients,37 patients with significantly higher MELD (19.03±9.61 vs 9.69±5.32), MELD-Na (24.75±12.98 vs 10.16±6.21), MESO (1.45±0.77 vs 0.71±0.40), iMELD (43.76±10.49 vs 30.09±7.01) compared to the survivors died within 3 months (P<0.01). In 233 patients,45 patients with significantly higher MELD (17.80±9.16 vs 9.59±5.38). MELD-Na (22.80±12.57 vs 10.00±6.25), MESO (1.35±0.74 vs 0.70±0.40), iMELD (42.28±10.08 vs 29.87±7.05) compared to the survivors died within 6 months (P<0.01) and 62 patients with significantly higher MELD (16.24±8.64 vs 9.34±5.33), MELD-Na (20.00±11.94 vs 9.74±6.29), MESO (1.22±0.69 vs 0.68±0.40), iMELD (39.41±10.35 vs 29.67±7.08) compared to the survivors died within 1 year (P<0.01). At 3 months of enrollment, the MELD-Na had the highest AUC (0.901) and was followed by the iMELD (0.891), MESO (0.835) and MELD (0.828). At 6 months of enrollment, the MELD-Na had the highest AUC (0.876) and was followed by the iMELD (0.874), MESO (0.815) and MELD (0.805). At 1 year of enrollment, the MELD-Na still had the highest AUC (0.828) and was followed by the iMELD (0.808), MESO (0.781) and MELD (0.775). All comparisons between MELD-Na and other models showed significant differences (P<0.05), with the exception of MELD-Na and iMELD. From the survival curves, the cut-offs of four models were indicated to discern that the patients would be survived or dead in 3 months and 1 year.ConclusionMELD and MELD-based models combination with serum sodium can predict the prognosis of patients with decompensated cirrhosis for short and intermediate period, and predict short period more exactly. In these four models, MELD-Na is better prognostic model in patients with decompensated cirrhosis.