Clinical and Molecular Hepatology

"Model for End-Stage Liver Disease"

Original Articles

Viral hepatitis

Static and dynamic prognostic factors for hepatitis-B-related acute-on-chronic liver failure: Jung Min Ha, Won Sohn, Ju Yeon Cho, Jeung Hui Pyo, Kyu Choi, Dong Hyun Sinn, Geum-Youn Gwak, Moon Seok Choi, Joon Hyeok Lee, Kwang Chul Koh, Seung Woon Paik, Byung Chul Yoo, Yong-Han Paik; Clin Mol Hepatol 2015;21(3):232-241.
Published online September 30, 2015; DOI: https://doi.org/10.3350/cmh.2015.21.3.232

Abstract
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Background/Aims

Hepatitis-B-related acute-on-chronic liver failure has a poor prognosis. However, the advent of potent oral antiviral agents means that some patients can now recover with medical treatment. We aimed to identify the prognostic factors for hepatitis-B-related acute-on-chronic liver failure including the initial as well as the dynamically changing clinical parameters during admission.

Methods

Sixty-seven patients were retrospectively enrolled from 2003 to 2012 at Samsung Medical Center. The patients were classified into three categories: Recovery group (n=23), Liver transplantation group (n=28), and Death group (n=16). The Liver transplantation and Death groups were combined into an Unfavorable prognosis group. We analyzed the prognostic factors including the Model for End-Stage Liver Disease (MELD) scores determined at 3-day intervals.

Results

A multivariable analysis showed that the unfavorable prognostic factors were a high initial MELD score (≥28) (odds ratio [OR] =6.64, p=0.015), moderate-to-severe ascites at admission (OR=6.71, P=0.012), and the aggravation of hepatic encephalopathy during hospitalization (≥grade III) (OR=15.41, P=0.013). Compared with the baseline level, significant reductions in the MELD scores were observed on the 7th day after admission in the Recovery group (P=0.016).

Conclusions

Dynamic changes in clinical parameters during admission are useful prognostic factors for hepatitis-B-related acute-on-chronic liver failure.

Citations

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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.; Korean J Hepatol 2009;15(3):350-356.
Published online September 30, 2009; DOI: https://doi.org/10.3350/kjhep.2009.15.3.350

Abstract
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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)

Citations

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Yonsei Medical Journal.2016; 57(1): 138. CrossRef
Evaluation of portal hypertension by real‐time shear wave elastography in cirrhotic patients
Tae Yeob Kim, Woo Kyoung Jeong, Joo Hyun Sohn, Jinoo Kim, Min Yeong Kim, Yongsoo Kim
Liver International.2015; 35(11): 2416. CrossRef
Relationship between the hepatic venous pressure gradient and first variceal hemorrhage in patients with cirrhosis: a multicenter retrospective study in Korea
Jin Nyoung Kim, Kyoung Min Sohn, Moon Young Kim, Ki Tae Suk, Soung Won Jeong, Ho Eun Jung, Sae Hwan Lee, Sang Gyune Kim, Jae Young Jang, Young Seok Kim, Soon Koo Baik, Hong Soo Kim, Dong Joon Kim, Boo Sung Kim
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