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Korean J Hepatol. 2007;13(1):51-60. Published online January 1, 1970.
- Usefulness of ΔMELD/month for Prediction of the Mortality in the First Episode of Variceal Bleeding Patients with Liver Cirrhosis: Comparison with CTP, MELD score and ΔCTP/month
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- Abstract
- Background/Aims
There are many models for predicting prognosis of liver cirrhosis including Child
Turcotte Pugh (CTP), the model for end-stage liver disease (MELD) score and its changes over time (ΔCTP
and ΔMELD/month). We investigated the ability of these models to predict the mortality of liver cirrhosis
patients with the first episode of variceal bleeding and which model can be usefully applied in practice.
Methods
Seventy-one liver cirrhosis patients hospitalized for the first episode of esophageal variceal bleeding
were retrospectively analyzed. The predictive power of initial CTP, MELD score, ΔCTP and ΔMELD/month
was compared through c-statistics and multiple logistic regression. Results: All of the prognostic predictors
measured higher in patients who survived than in those who died. The area under the receiver operating
characteristic (ROC) curve for ΔMELD/month in 6 months was 1, a higher value than 0.81 for initial CTP,
0.75 for initial MELD, and 0.84 for ΔCTP/month; the area of ΔMELD/month in 12 months was 0.81, also
showing a higher value than others. ΔMELD/month > 0.27 was a strong significant prognostic predictor in 6
(odds ratio: 40.1, p=0.001) and 12 months (odds ratio: 14.1, p<0.001). Only the ΔMELD/month was an
independent prognostic predictor with a risk ratio of 1.604 (95% CI: 1.119-2.302, p=0.01) in 6 months and 1.627
(95% CI: 1.294-2.047, p<0.001) in 12 months. Conclusions: The ΔMELD/month is superior to initial CTP,
MELD and ΔCTP/month to predict 6 and 12 months mortality in liver cirrhosis patients with the first episode
of variceal bleeding. (Korean J Hepatol 2007;13:51-60)
Keywords :Variceal bleeding; Fatal outcome; CTP; MELD; ΔCTP/month; ΔMELD/month
