MELD vs Child-Pugh and creatinine-modified Child-Pugh score for predicting survival in patients with decompensated cirrhosis

Papatheodoridis, GV; Cholongitas, E; Dimitriadou, E; Touloumi, G; Sevastianos, V; Archimandritis, AJ

dc.contributor.author	Papatheodoridis, GV	en
dc.contributor.author	Cholongitas, E	en
dc.contributor.author	Dimitriadou, E	en
dc.contributor.author	Touloumi, G	en
dc.contributor.author	Sevastianos, V	en
dc.contributor.author	Archimandritis, AJ	en
dc.date.accessioned	2014-03-01T01:54:37Z
dc.date.available	2014-03-01T01:54:37Z
dc.date.issued	2005	en
dc.identifier.issn	1007-9327	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/27449
dc.subject	Child-Pugh	en
dc.subject	MELD	en
dc.subject	Cirrhosis	en
dc.subject	Decompensated cirrhosis	en
dc.subject.classification	Gastroenterology & Hepatology	en
dc.title	MELD vs Child-Pugh and creatinine-modified Child-Pugh score for predicting survival in patients with decompensated cirrhosis	en
heal.type	journalArticle	en
heal.language	English	en
heal.publicationDate	2005	en
heal.abstract	AIM: Model of End-stage Liver Disease (MELD) score has recently gained wide acceptance over the old Child-Pugh score in predicting survival in patients with decompensated cirrhosis, although it is more sophisticated. We compared the predictive values of MELD, Child-Pugh and creatinine-modified Child-Pugh scores in decompensated cirrhosis. METHODS: A cohort of 102 patients with decompensated cirrhosis followed-up for a median of 6 mo was studied. Two types of modified Child-Pugh scores estimated by adding 0-4 points to the original score using creatinine levels as a sixth categorical variable were evaluated. RESULTS: The areas under the receiver operating characteristic curves did not differ significantly among the four scores, but none had excellent diagnostic accuracy (areas: 0.71-0.79). Child-Pugh score appeared to be the worst, while the accuracy of MELD was almost identical with that of modified Child-Pugh in predicting short-term and slightly better in predicting medium-term survival. In Cox regression analysis, all four scores were significantly associated with survival, while MELD and creatinine-modified Child-Pugh scores had better predictive values (c-statistics: 0.73 and 0.69-0.70) than Child-Pugh score (c-statistics: 0.65). Adjustment for gamma-glutamate transpeptidase levels increased the predictive values of all systems (c-statistics: 0.77-0.81). Analysis of the expected and observed survival curves in patients subgroups according to their prognosis showed that all models fit the data reasonably well with MELD probably discriminating better the subgroups with worse prognosis. CONCLUSION: MELD compared to the old Child-Pugh and particularly to creatinine-modified Child-Pugh scores does not appear to offer a clear advantage in predicting survival in patients with decompensated cirrhosis in daily clinical practice. (C) 2005 The WJG Press and Elsevier Inc. All rights reserved.	en
heal.publisher	BAISHIDENG PUBL GRP CO LTD	en
heal.journalName	WORLD JOURNAL OF GASTROENTEROLOGY	en
dc.identifier.isi	ISI:000208098600017	en
dc.identifier.volume	11	en
dc.identifier.issue	20	en
dc.identifier.spage	3099	en
dc.identifier.epage	3104	en