PROGNOSTIC VALUE OF MELD SCORE IN CHILD PUGH C CIRRHOTIC PATIENTS

Abstract

Background and aims: The Model for End Stage Liver Disease (MELD) is a scoring system used for the prioritization of patients waiting for liver transplantation. Patients with decompensated cirrhosis often have serious complications. The aims of this study were to evaluate the prognostic value of MELD score in relation to mortality complications and to acute variceal bleeding, spontaneous bacterial peritonitis, hepatoencephalopathy, hepatorenal syndrome of Child Pugh C Vietnamese cirrhotic patients in a period of six months after hospitalization. Methods: This prospective study includes 102 consecutive Child Pugh C cirrhotic patients who were admitted to the Gastrointestinal Department of Hue Central Hospital and the General Internal Medicine Department of Hue University of Medicine and Pharmacy Hospital, Vietnam, from April 2016 to February 2017. The MELD score of each patient was calculated at admission. All patients were then observed for 6 months to assess the following: acute variceal bleeding, spontaneous bacterial peritonitis, hepatoencephalopathy, hepatorenal syndrome and mortality. Results: The mean MELD score of all patients was 19.5 ± 7.1; of male patients was 19.7 ± 7.4; of female patients was 18.43 ± 4.4; of alcoholic patients was 19.5 ±7.5; and of non – alcoholic patients was 19.6 ± 5.9. The MELD score correlated with mortality during 6 months after hospitalization (with cut – off = 20; AUC = 0,69; sensitivity and specificity were 56.0% and 76.6%) and with hepatorenal syndrome (with cut – off = 25; AUC = 0.90; sensitivity = 83.3% and specificity = 85.4%). In this study, the MELD score did not correlated acute variceal bleeding, spontaneous bacterial peritonitis, hepatoencephalopathy during 6 months after hospitalization. Conclusion: MELD is a valuable prognostic score for mortality and hepatorenal syndrome in Child Pugh C cirrhotic patients in 6 months after hospitalization. Key words: MELD score, Child Pugh C cirrhotic patients