[Model for end-stage liver disease-sodium predicts prognosis in patients with chronic severe hepatitis B].

Abstract

OBJECTIVES:

To study the practical use of the serum sodium incorporated model for end-stage liver disease (MELD-Na) on clinic and to assess its validity by the concordance-statistic in predicting the prognosis of the patients with chronic severe hepatitis B.

METHODS:

Adult patients with a diagnosis of chronic severe hepatitis B between January 2007 and December 2007 in a single center were analyzed. The serum sodium, MELD, MELD-Na, and Delta MELD-Na (Delta MELD=MELD score at 14 days after medical treatment-MELD score at admission) scores of 426 patients with chronic severe hepatitis B were calculated. The 3-month mortality in patients was measured, and the validity of the models was determined by means of the concordance-statistic.

RESULTS:

The area under the receiver-operating characteristic curves of Na, MELD and MELD-Na for the occurrence of death in 3 month were 0.718, 0.875 and 0.922. The 3-month mortality of the MELD-Na scores group <25, 25-30, >30-35, >35- <40 and > or = 40 were 2.0%, 5.4%, 35.4%, 53.8% and 86.9% respectively. There was a significant difference of 3-month mortality between the five groups (P<0.05). The 3-month mortality of Delta MELD-Na> 0 group was 65.9%, and the Delta MELD-Na < or = 0 group was 15.8%. There was a significant difference of 3-month mortality between the two groups (P<0.05).

CONCLUSIONS:

MELD-Na score is a valid model to predict 3-month mortality in patients with chronic severe hepatitis B. Delta MELD-Na is clinically useful parameters for predicting the therapeutic effect of chronic severe hepatitis B.

• Authors: Hu-an Chen, Ying-hua Chen, Hui Zhao, Shu-hong Yi, Jun-feng Zhang, Wei Meng, Chang-jie Cai, Min-qiang Lu, Gui-hua Chen
• Journal: Zhonghua wai ke za zhi [Chinese journal of surgery] (Zhonghua Wai Ke Za Zhi) Vol. 47 Issue 23 Pg. 1771-4 (Dec 01 2009) ISSN: 0529-5815 [Print] China
• PMID: 20193543 (Publication Type: Journal Article, Validation Study)

Topics

• Adolescent
• Adult
• Aged
• End Stage Liver Disease
• Female
• Follow-Up Studies
• Hepatitis B, Chronic (mortality)
• Humans
• Male
• Middle Aged
• Models, Statistical
• Prognosis
• Retrospective Studies
• Severity of Illness Index
• Young Adult