| Background and Objective: Once patients with cirrhosis experience decompensation of liver function, the mortality risk increases sharply. With the new treatment of liver diseases emerging, clinicians need to accurately judge the condition of the liver disease, to select individualized treatment. Most scholars adopted the Child-Turcotte score which proposed by Child and Turcotte for the first time in 1964 and revised by Pugh in 1973. Child-Pugh score including serum bilirubin , serum albumin, ascites, hepatic encephalopathy, prothrombin time extension or prothrombin activity (%). According to the total score , the severity of liver function was divided into 3 greed of A, B and C. Child-Pugh score has been the reference for many years for assessing the prognosis of cirrhosis. However, Child-Pugh score has important limitations among which is subjective interpretation of some of its variables, making it difficult to categorize patients according to their own disease severity. Kamath of Mayo medical center raised a new evaluation system, namely MELD score (the Model for End-Stage Liver Disease) in 2001: MELDscore= 3.8×In (TBIL mg / dl) +11.2×In (INR) + 9.6×In (Cr mg / dl) +6.4×(etiology: cholestasis or alcoholic to 0, the other for 1) . The more the MELD score , the worse the prognosis. The MELD score, which was originally designed for assessing the prognosis of cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt (TIPS), is a continuous score relying on three objective variables. Along with TIPS, MELD score proved to be a robust marker of early mortality across a wide spectrum of causes of cirrhosis. MELD score attracts widely attention because its simple, objective, accurate. This paper aimed to analyse the clinical data of 188 patients with decompensated cirrhosis and to compare the application between MELD score and Child-Pugh classification in determining the short-term prognosis of patients with hepatic cirrhosis.Method: Retrospective data from 188 patients with liver cirrhosis were analysed. According to death or not 3 monthes after hospitolized, patients were dvided into into the survival group and the died group. MELD score and Child-Pugh were Calculated , and the mortality of patients with different MELD score(≤9,10 ~ 19,20 ~ 29,≥30) and different Child-Pugh classification (A, B, C-class) were compared. Prediction of mortality for three months were analyzed using the area under the receiver's operating characteristics curve (AUC). Statistical analysis: using the t-test and Che-square test analysis, the database which established by Excel software and arranged by SPSS 11.5 software. Standardsα= 0. 05.Results:1.The mean of MELD scores in the died group was (25.57±8.55), the survival group was (19.09±6.33) . There was significant difference between the two groups (t = -2.190, P = 0.001). The mortality of patients whose MELD scores were≤9,10~19,20~29,≥30 was 11.36%, 27.27%, 47.73% and 13.64% respectively in died group. In survival group, the patients with MELD≤9,10~19, 20~29,≥30 was 45.83%,43.75%,9.03% and 1.39% respectively. The differences between two groups in each range of the MELD scores were significant.2.The mean score of Child-Pugh in the died group was (12.07±1.81), in the survival group was (8.90±1.92) . The difference between the two groups was significant (t = 9.701, P = 0.000). In died group, the mortality of patients with Child-Pugh class A, B and C was 6.82%, 47.73% and 6.25% respectively. In survival group, the patients with Child-Pugh class A, B and C was 58.34%, 35.42% and 6.25% respectly. The died group and survival group had a significant difference in the Child-Pugh class A and C (P = 0.000).3.MELD and Child-Pugh receiver operating characteristic (ROC) curve was 0.804 (95% CI 0.730 ~ 0.878), 0.818 (95% CI 0.747 ~ 0.889), the difference was not significant (P> 0.05). 4.There was 117 cases occured serious complications, the propotion was 62.23%. In death group, 33 cases of hepatic encephalopathy, accounting for 75.00%(33/44) ; 21 cases of spontaneous bacterial peritonitis, accounting for 47.73% ; 21 cases of upper gastrointestinal bleeding, accounting for 47.73%(21/44); 12 cases of hepatorenal syndrome; accounting for 27.27% (12/44). In the survival group, 13 cases of hepatic encephalopathy, accounting for 9.03% (13/144); 31 cases of spontaneous bacterial peritonitis, accounting for 21.53% (31/144); 35 cases of upper gastrointestinal bleeding, accounting for 24.31% (35/144); 3 cases of hepatorenal syndrome, accounting for 2.08% (3/144). 44 patients died 3 monthes after first hospitalization. The mortality was 23.40%. The incidence of complications between the died group and the survival group is significantly different (P = 0.000-0.003).Conclusion:1.The prognosis of patients with lower MELD score were better than those with higher score. The prognosis of patients with Child-Pugh classification A is better than those with Child-Pugh classification C.2.Both MELD score and Child-Pugh classification can predict the short term prognosis of patients with decompensated liver cirrhosis. MELD score can not completely replace the Child-Pugh classification.3. The incidence of complications in the deaths group was obviously higher than the survival group.There had a statistically significant. It suggested that the prognosis of complications is an important indicator of liver function, and should be reflected in the evaluation system.
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