Child-Pugh versus MELD score for predicting the in-hospital mortality of acute upper gastrointestinal bleeding in liver cirrhosis

Abstract

A retrospective study was conducted to compare the performance of Child-Pugh and Model for End-Stage Liver Diseases (MELD) scores for predicting the in-hospital mortality of acute upper gastrointestinal bleeding (UGIB) in patients with liver cirrhosis. A total of 145 patients with a diagnosis of liver cirrhosis and acute UGIB between July 2013 and June 2014 were retrospectively analyzed (male/female: 94/51; mean age: 56.77±11.33 years; Child-Pugh class A/B/C: 46/64/35; mean Child-Pugh score: 7.88±2.17; mean MELD score: 7.86±7.22). The in-hospital mortality was 8% (11/145). Areas under receiving-operator characteristics curve (AUROC) for predicting the in-hospital mortality were compared between MELD and Child-Pugh scores. AUROCs for predicting the in-hospital mortality for Child-Pugh and MELD scores were 0.796 (95% confidence interval [CI]: 0.721-0.858) and 0.810 (95% CI: 0.736-0.870), respectively. The discriminative ability was not significant different between the two scoring systems (P=0.7241). In conclusion, Child-Pugh and MELD scores were similar for predicting the in-hospital mortality of acute UGIB in cirrhotic patients.

Keywords: Child-Pugh; Liver cirrhosis; MELD; gastrointestinal bleeding; prognosis.

Figures

Figure 1

Patient selection.

Figure 2

ROC analysis of Child-Pugh scores for predicting the in-hospital mortality of acute UGIB in liver cirrhosis.

Figure 3

ROC analysis of MELD scores for predicting the in-hospital mortality of acute UGIB in liver cirrhosis.

Figure 4

Comparison of the performance of Child-Pugh and MELD scores for predicting the in-hospital mortality of acute UGIB in liver cirrhosis.