Evaluation of model for end stage liver disease for estimation of short-term prognosis in decompensated cirrhosis

Objective To evaluate the short-term prognostic value of model of end stage liver disease (MELD) , MELD-Na, Child-Turcotte-Pugh (CTP) and the creatinine modified CTP (CrCTP) grading in patients with decompensated liver cirrhosis.Methods 265 patients with decompensated liver cirrhosis were enrolled in the study.The MELD, MELD-Na, CTP and CrCTP scores were calculated for each patient on the first time of admission and their mortality within 3 months was observed.Receiver operating characteristic curve (ROC) and the area under the curve (AUC) were used to analyze and compare the values of the four models to predict the 3-month survival.Results 58 patients died within 3 months.MELD, MELD-Na, CTP and CrCTP scores for non-survivors (22.15±5.67, 31.45±8.50, 11.60±2.70, 12.72±2.54) were significantly higher (P<0.01) than those for survivors (12.35±3.56, 17.24±4.75, 8.73±2.35, 9.05±2.50) .There were significant differences between the two groups in MELD and CTP grade (P<0.01) .For 3-month predictive prognosis, the area under ROC of MELD, MELD-Na, CTP and CrCTP were 0.875, 0.868, 0.758 and 0.794 respectively.MELD was superior to CTP in predicting short-term of patients with decompensated liver cirrhosis.There was no difference between MELD, MELD-Na and CrCTP.Conclusion MELD, MELD-Na, CTP and CrCTP scores can accurately predict the 3-month survival of patients with decompensated liver cirrhosis.The MELD score is superior to CTP score for estimation of short-term survival in patients with decompensated cirrhosis.