Comparison of the Model for End-stage Liver Disease and hepatic venous pressure gradient for predicting survival in patients with decompensated Liver cirrhosis

doi:2009.15.3.350

Korean J Hepatol > Volume 15(3); 2009 > Article

The Korean Journal of Hepatology 2009;15(3): 350-356.
doi: https://doi.org/10.3350/kjhep.2009.15.3.350

Comparison of the Model for End-stage Liver Disease and hepatic venous pressure gradient for predicting survival in patients with decompensated Liver cirrhosis

Sung Hoa Lee, M.D., Seung Ha Park, M.D., Go Woon Kim, M.D., Woo Jin Lee, M.D., Won Ki Hong, M.D., Myeong Shin Ryu, M.D., Kyu Tae Park, M.D., Min Young Lee, M.D., Chan Woo Lee, M.D., Jin Ho Kim, M.D., Yong Mook Kim, M.D., Sung Jung Kim, M.D., Gwang Ho Baik, M.D., Jin Bong Kim, M.D., Dong Joon Kim, M.D.

Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea

ABSTRACT

Backgrounds
/Aims: This study compared the prognostic values of the Model for End-stage Liver Disease (MELD) and the hepatic venous pressure gradient (HVPG) in the prediction of death within 3 and 12 months in patients with decompensated liver cirrhosis. Methods: We used data from 136 consecutive patients with decompensated cirrhosis who underwent HVPG between January 2006 and June 2008. Cox regression analysis was used to investigate the independent relationships with death of MELD and HVPG. The prognostic accuracies of MELD and HVPG were analyzed by calculating the area under the receiver operating characteristic curve (AUROC) for the occurrence of death within 3 and 12 months. Results: Both MELD and HVPG were independent predictors of death [hazard ratio (HR)=1.11 and 1.12, respectively; 95% confidence interval (CI)=1.04~1.20 and 1.08-1.16]. Analysis of the AUROC demonstrated that the prognostic power did not differ between MELD and HVPG for predicting the 3-month survival (HR=0.76 and 0.68, respectively; 95% CI=0.62~0.89 and 0.52~0.84; P=0.22) or the 12-month survival (HR=0.72 and 0.73, 95% CI=0.61~0.83 and CI=0.61~0.84). Conclusions: Both MELD and HVPG are independent prognostic factors of death within 3 and 12 months in patients with decompensated liver cirrhosis, and their accuracies are similar. However, HVPG has a limited role in the prediction of death in decompensated cirrhosis due to its invasiveness and limited use. (Korean J Hepatol 2009;15:350-356)

KeyWords: Decompensated; Cirrhosis; Model for End-stage Liver Disease; Hepatic Venous Pressure Gradient; Prognosis