Child-Pugh Versus MELD Score for the Assessment of Prognosis in Liver Cirrhosis: A Systematic Review and Meta-Analysis of Observational Studies

Ying Peng, Xingshun Qi, Xiaozhong Guo, Ying Peng, Xingshun Qi, Xiaozhong Guo

Abstract

Child-Pugh and MELD scores have been widely used for the assessment of prognosis in liver cirrhosis. A systematic review and meta-analysis aimed to compare the discriminative ability of Child-Pugh versus MELD score to assess the prognosis of cirrhotic patients.PubMed and EMBASE databases were searched. The statistical results were summarized from every individual study. The summary areas under receiver operating characteristic curves, sensitivities, specificities, positive and negative likelihood ratios, and diagnostic odds ratios were also calculated.Of the 1095 papers initially identified, 119 were eligible for the systematic review. Study population was heterogeneous among studies. They included 269 comparisons, of which 44 favored MELD score, 16 favored Child-Pugh score, 99 did not find any significant difference between them, and 110 did not report the statistical significance. Forty-two papers were further included in the meta-analysis. In patients with acute-on-chronic liver failure, Child-Pugh score had a higher sensitivity and a lower specificity than MELD score. In patients admitted to ICU, MELD score had a smaller negative likelihood ratio and a higher sensitivity than Child-Pugh score. In patients undergoing surgery, Child-Pugh score had a higher specificity than MELD score. In other subgroup analyses, Child-Pugh and MELD scores had statistically similar discriminative abilities or could not be compared due to the presence of significant diagnostic threshold effects.Although Child-Pugh and MELD scores had similar prognostic values in most of cases, their benefits might be heterogeneous in some specific conditions. The indications for Child-Pugh and MELD scores should be further identified.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Flowchart of study inclusion.

References

    1. Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380:2095–2128.
    1. Blachier M, Leleu H, Peck-Radosavljevic M, et al. The burden of liver disease in Europe: a review of available epidemiological data. J Hepatol 2013; 58:593–608.
    1. D’Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol 2006; 44:217–231.
    1. Pugh RN, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 1973; 60:646–649.
    1. Malinchoc M, Kamath PS, Gordon FD, et al. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology (Baltimore, MD) 2000; 31:864–871.
    1. Kamath PS, Kim WR, Advanced Liver Disease Study G. The model for end-stage liver disease (MELD). Hepatology (Baltimore, MD) 2007; 45:797–805.
    1. Bedreli S, Sowa JP, Gerken G, et al. Management of acute-on-chronic liver failure: rotational thromboelastometry may reduce substitution of coagulation factors in liver cirrhosis. Gut 2016; 65:357–358.
    1. Trotter JF, Olson J, Lefkowitz J, et al. Changes in international normalized ratio (INR) and model for endstage liver disease (MELD) based on selection of clinical laboratory. Am J Transplant 2007; 7:1624–1628.
    1. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 2011; 155:529–536.
    1. An J, Kim KW, Han S, et al. Improvement in survival associated with embolisation of spontaneous portosystemic shunt in patients with recurrent hepatic encephalopathy. Aliment Pharmacol Ther 2014; 39:1418–1426.
    1. Angermayr B, Cejna M, Karnel F, et al. Child-Pugh versus MELD score in predicting survival in patients undergoing transjugular intrahepatic portosystemic shunt. Gut 2003; 52:879–885.
    1. Arif R, Seppelt P, Schwill S, et al. Predictive risk factors for patients with cirrhosis undergoing heart surgery. Ann Thorac Surg 2012; 94:1947–1952.
    1. Attia KA, Ackoundou-N’guessan KC, N’Dri-Yoman AT, et al. Child-Pugh-Turcott versus Meld score for predicting survival in a retrospective cohort of black African cirrhotic patients. World J Gastroenterol 2008; 14:286–291.
    1. Augustin S, Muntaner L, Altamirano JT, et al. Predicting early mortality after acute variceal hemorrhage based on classification and regression tree analysis. Clin Gastroenterol Hepatol 2009; 7:1347–1354.
    1. Bae WK, Lee JS, Kim NH, et al. [Usefulness of DeltaMELD/month for prediction of the mortality in the first episode of variceal bleeding patients with liver cirrhosis: comparison with CTP, MELD score and DeltaCTP/month]. Korean J Hepatol 2007; 13:51–60.
    1. Bang CS, Suk KT, Kim DJ. Clinical significance of hepatic venous pressure gradient measurement in the risk assessment of hepatocellular carcinoma. Hepatol Int 2014; 8:S387.
    1. Befeler AS, Palmer DE, Hoffman M, et al. The safety of intra-abdominal surgery in patients with cirrhosis: model for end-stage liver disease score is superior to Child-Turcotte-Pugh classification in predicting outcome. Arch Surg (Chicago, Ill: 1960) 2005; 140:650–654.discussion 5.
    1. Benedeto-Stojanov D, Nagorni A, Bjelakovic G, et al. The model for the end-stage liver disease and Child-Pugh score in predicting prognosis in patients with liver cirrhosis and esophageal variceal bleeding. Vojnosanitet Pregl 2009; 66:724–728.
    1. Bhise SB, Dias RJ, Mali KK. Prognostic value of the monoethylglycinexylidide test in alcoholic cirrhosis. Saudi J Gastroenterol 2007; 13:118–123.
    1. Bie CQ, Yang DH, Tang SH, et al. Value of (Delta)MELD in evaluating the prognosis of patients with decompensated cirrhosis. World Chin J Digestol 2007; 15:3135–3139.
    1. Bie CQ, Yang DH, Tang SH, et al. The value of model for end-stage liver disease and Child-Turcotte-Pugh scores over time in evaluating the prognosis of patients with decompensated cirrhosis: experience in the Chinese mainland. Hepatol Res 2009; 39:779–785.
    1. Biselli M, Dall’Agata M, Gramenzi A, et al. A new prognostic model to predict dropout from the waiting list in cirrhotic candidates for liver transplantation with MELD score <18. Liver Int 2015; 35:184–191.
    1. Boin Ide F, Leonardi MI, Udo EY, et al. [The application of MELD score in patients submitted to liver transplantation: a retrospective analysis of survival and the predictive factors in the short and long term]. Arq Gastroenterol 2008; 45:275–283.
    1. Botta F, Giannini E, Romagnoli P, et al. MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study. Gut 2003; 52:134–139.
    1. Boursier J, Cesbron E, Tropet AL, et al. Comparison and improvement of MELD and Child-Pugh score accuracies for the prediction of 6-month mortality in cirrhotic patients. J Clin Gastroenterol 2009; 43:580–585.
    1. Cerqueira RM, Andrade L, Correia MR, et al. Risk factors for in-hospital mortality in cirrhotic patients with oesophageal variceal bleeding. Eur J Gastroenterol Hepatol 2012; 24:551–557.
    1. Chan HL, Chim AM, Lau JT, et al. Evaluation of model for end-stage liver disease for prediction of mortality in decompensated chronic hepatitis B. Am J Gastroenterol 2006; 101:1516–1523.
    1. Chaurasia RK, Pradhan B, Chaudhary S, et al. Child-Turcotte-Pugh versus model for end stage liver disease score for predicting survival in hospitalized patients with decompensated cirrhosis. J Nepal Health Res Counc 2013; 11:9–16.
    1. Chawla YK, Kashinath RC, Duseja A, et al. Predicting Mortality Across a Broad Spectrum of Liver Disease-An Assessment of Model for End-Stage Liver Disease (MELD), Child-Turcotte-Pugh (CTP), and Creatinine-Modified CTP Scores. J Clin Exp Hepatol 2011; 1:161–168.
    1. Chen CH, Shih CM, Chou JW, et al. Outcome predictors of cirrhotic patients with spontaneous bacterial empyema. Liver Int 2011; 31:417–424.
    1. Chen H, Bai M, Qi X, et al. Child-Na score: a predictive model for survival in cirrhotic patients with symptomatic portal hypertension treated with TIPS. PloS One 2013; 8:e79637.
    1. Cho HC, Jung HY, Sinn DH, et al. Mortality after surgery in patients with liver cirrhosis: comparison of Child-Turcotte-Pugh, MELD and MELDNa score. Eur J Gastroenterol Hepatol 2011; 23:51–59.
    1. Choi PC, Kim HJ, Choi WH, et al. Model for end-stage liver disease, model for end-stage liver disease-sodium and Child-Turcotte-Pugh scores over time for the prediction of complications of liver cirrhosis. Liver Int 2009; 29:221–226.
    1. Cholongitas E, Betrosian A, Senzolo M, et al. Prognostic models in cirrhotics admitted to intensive care units better predict outcome when assessed at 48 h after admission. J Gastroenterol Hepatol 2008; 23 ((8 Pt 1)):1223–1227.
    1. Corneille MG, Nicholson S, Richa J, et al. Liver dysfunction by model for end-stage liver disease score improves mortality prediction in injured patients with cirrhosis. J Trauma 2011; 71:6–11.
    1. Costa BP, Sousa FC, Serodio M, et al. Value of MELD and MELD-based indices in surgical risk evaluation of cirrhotic patients: retrospective analysis of 190 cases. World J Surg 2009; 33:1711–1719.
    1. Das V, Boelle PY, Galbois A, et al. Cirrhotic patients in the medical intensive care unit: early prognosis and long-term survival. Crit Care Med 2010; 38:2108–2116.
    1. Degre D, Bourgeois N, Boon N, et al. Aminopyrine breath test compared to the MELD and Child-Pugh scores for predicting mortality among cirrhotic patients awaiting liver transplantation. Transpl Int 2004; 17:31–38.
    1. Dhiman RK, Agrawal S, Gupta T, et al. Chronic Liver Failure-Sequential Organ Failure Assessment is better than the Asia-Pacific Association for the Study of Liver criteria for defining acute-on-chronic liver failure and predicting outcome. World J Gastroenterol 2014; 20:14934–14941.
    1. Duseja A, Choudhary NS, Gupta S, et al. APACHE II score is superior to SOFA, CTP and MELD in predicting the short-term mortality in patients with acute-on-chronic liver failure (ACLF). J Dig Dis 2013; 14:484–490.
    1. Ecochard M, Boillot O, Guillaud O, et al. Could metabolic liver function tests predict mortality on waiting list for liver transplantation? A study on 560 patients. Clin Transpl 2011; 25:755–765.
    1. Emerson P, McPeake J, O’Neill A, et al. The utility of scoring systems in critically ill cirrhotic patients admitted to a general intensive care unit. J Crit Care 2014; 29:1131.e1–1131.e6.
    1. Fede G, Spadaro L, Tomaselli T, et al. Assessment of adrenocortical reserve in stable patients with cirrhosis. J Hepatol 2011; 54:243–250.
    1. Fejfar T, Safka V, Hulek P, et al. [MELD score in prediction of early mortality in patients suffering refractory ascites treated by TIPS]. Vnitr Lek 2006; 52:771–776.
    1. Flores-Rendon AR, Gonzalez-Gonzalez JA, Garcia-Compean D, et al. Model for end stage of liver disease (MELD) is better than the Child-Pugh score for predicting in-hospital mortality related to esophageal variceal bleeding. Ann Hepatol 2008; 7:230–234.
    1. Giannini E, Botta F, Fumagalli A, et al. Can inclusion of serum creatinine values improve the Child-Turcotte-Pugh score and challenge the prognostic yield of the model for end-stage liver disease score in the short-term prognostic assessment of cirrhotic patients? Liver Int 2004; 24:465–470.
    1. Gomez EV, Bertot LC, Gra Oramas B, et al. Application of a biochemical and clinical model to predict individual survival in patients with end-stage liver disease. World J Gastroenterol 2009; 15:2768–2777.
    1. Gotthardt D, Weiss KH, Baumgartner M, et al. Limitations of the MELD score in predicting mortality or need for removal from waiting list in patients awaiting liver transplantation. BMC Gastroenterol 2009; 9:72.
    1. Gotzberger M, Singer J, Kaiser C, et al. Intrarenal resistance index as a prognostic parameter in patients with liver cirrhosis compared with other hepatic scoring systems. Digestion 2012; 86:349–354.
    1. Grunhage F, Rezori B, Neef M, et al. Elevated soluble tumor necrosis factor receptor 75 concentrations identify patients with liver cirrhosis at risk of death. Clin Gastroenterol Hepatol 2008; 6:1255–1262.
    1. Hassan EA, Abd El-Rehim AS. A revised scope in different prognostic models in cirrhotic patients: Current and future perspectives, an Egyptian experience. Arab J Gastroenterol 2013; 14:158–164.
    1. Hoteit MA, Ghazale AH, Bain AJ, et al. Model for end-stage liver disease score versus Child score in predicting the outcome of surgical procedures in patients with cirrhosis. World J Gastroenterol 2008; 14:1774–1780.
    1. Huo TI, Lin HC, Wu JC, et al. Different model for end-stage liver disease score block distributions may have a variable ability for outcome prediction. Transplantation 2005; 80:1414–1418.
    1. Huo TI, Lin HC, Wu JC, et al. Proposal of a modified Child-Turcotte-Pugh scoring system and comparison with the model for end-stage liver disease for outcome prediction in patients with cirrhosis. Liver Transpl 2006; 12:65–71.
    1. Huo TI, Wu JC, Lin HC, et al. Evaluation of the increase in model for end-stage liver disease (DeltaMELD) score over time as a prognostic predictor in patients with advanced cirrhosis: risk factor analysis and comparison with initial MELD and Child-Turcotte-Pugh score. J Hepatol 2005; 42:826–832.
    1. Hyun JJ, Seo YS, Yoon E, et al. Comparison of the efficacies of lamivudine versus entecavir in patients with hepatitis B virus-related decompensated cirrhosis. Liver Int 2012; 32:656–664.
    1. Ishizu Y, Kuzuya T, Honda T, et al. A simple scoring system using MELD-Na and the stage of hepatocellular carcinoma for prediction of early mortality after acute variceal bleeding in patients with liver cirrhosis. Hepatology (Baltimore, MD) 2014; 60:1193A.
    1. Jalan R, Saliba F, Pavesi M, et al. Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. J Hepatol 2014; 61:1038–1047.
    1. Jiang CM, Xie W, Wang ZH. Prognostic evaluation for patients with decompensated hepatic cirrhosis. J Dalian Med Univ 2009; 31:67–70.
    1. Jiang J, Ye JJ, Liu GY, et al. Visualization of the biliary ducts on contrast enhanced MR cholangiography with Gd-EOB-DTPA: Relation with liver function in patients with liver cirrhosis. Chin J Med Imaging Technol 2013; 29:765–769.
    1. Kalabay L, Graf L, Voros K, et al. Human serum fetuin A/alpha2HS-glycoprotein level is associated with long-term survival in patients with alcoholic liver cirrhosis, comparison with the Child-Pugh and MELD scores. BMC Gastroenterol 2007; 7:15.
    1. Khan R, Abid S, Jafri W, et al. Model for end-stage liver disease (MELD) score as a useful prognostic marker in cirrhotic patients with infection. J Coll Physicians Surg Pak 2009; 19:694–698.
    1. Kim DH, Kim SH, Kim KS, et al. Predictors of mortality in cirrhotic patients undergoing extrahepatic surgery: comparison of Child-Turcotte-Pugh and model for end-stage liver disease-based indices. ANZ J Surg 2014; 84:832–836.
    1. Kim SY, Yim HJ, Lee J, et al. [Comparison of CTP, MELD, and MELD-Na scores for predicting short term mortality in patients with liver cirrhosis]. Korean J Gastroenterol 2007; 50:92–100.
    1. Kim TY, Kim MY, Sohn IH, et al. Sarcopenia as a useful predictor for long-term mortality in cirrhotic patients with ascites. J Korean Med Sci 2014; 29:1253–1259.
    1. Koo JK, Kim JH, Choi YJ, et al. Predictive value of Refit Model for End-Stage Liver Disease, Refit Model for End-Stage Liver Disease-Na, and pre-existing scoring system for 3-month mortality in Korean patients with cirrhosis. J Gastroenterol Hepatol 2013; 28:1209–1216.
    1. Krishnan A. Assessment of an optimal prognostic system for predicting mortality in patients awaiting liver transplantation: CTP vs meld. HPB 2013; 15:15.
    1. Kwon HJ, Koo KH, Han BH, et al. The prognostic value of hyponatremia in a well-defined population of patients with ascites due to cirrhosis. Hepatol Int 2014; 8:S386.
    1. Lee JY, Lee JH, Kim SJ, et al. [Comparison of predictive factors related to the mortality and rebleeding caused by variceal bleeding: Child-Pugh score, MELD score, and Rockall score]. J Hepatol 2002; 8:458–464.
    1. Lee M, Lee JH, Oh S, et al. CLIF-SOFA scoring system accurately predicts short-term mortality in acutely decompensated patients with alcoholic cirrhosis: a retrospective analysis. Liver Int 2015; 35:46–57.
    1. Levesque E, Hoti E, Azoulay D, et al. Prospective evaluation of the prognostic scores for cirrhotic patients admitted to an intensive care unit. J Hepatol 2012; 56:95–102.
    1. Lim LG, Tan XX, Woo SJ, et al. Risk factors for mortality in cirrhotic patients with sepsis. Hepatol Int 2011; 5:800–807.
    1. Lim SG, Lim LG, Xuan X, et al. Risk factors for mortality in cirrhotic patients with sepsis. Hepatology (Baltimore, MD) 2009; 50:454A.
    1. Lv XH, Liu HB, Wang Y, et al. Validation of model for end-stage liver disease score to serum sodium ratio index as a prognostic predictor in patients with cirrhosis. J Gastroenterol Hepatol 2009; 24:1547–1553.
    1. Mallaiyappan M, Sawalakhe NR, Sasidharan M, et al. Retrospective and prospective validation of model for end-stage liver disease (MELD) score in predicting mortality in patients of alcoholic liver disease. Trop Gastroenterol 2013; 34:252–258.
    1. Mishra P, Desai N, Alexander J, et al. Applicability of MELD as a short-term prognostic indicator in patients with chronic liver disease: an Indian experience. J Gastroenterol Hepatol 2007; 22:1232–1235.
    1. Moreno JP, Grandclement E, Monnet E, et al. Plasma copeptin, a possible prognostic marker in cirrhosis. Liver Int 2013; 33:843–851.
    1. Mouelhi L, Ben Hammouda I, Salem M, et al. Hospital mortality in cirrhotic patients admitted in intensive care unit: prognosis factors and impact of gravity scores. J Afr d’Hepato-Gastroenterol 2010; 4:17–21.
    1. Nunes D, Fleming C, Offner G, et al. Noninvasive markers of liver fibrosis are highly predictive of liver-related death in a cohort of HCV-infected individuals with and without HIV infection. Am J Gastroenterol 2010; 105:1346–1353.
    1. Olmez S, Gumurdulu Y, Tas A, et al. Prognostic markers in cirrhotic patients requiring intensive care: a comparative prospective study. Ann Hepatol 2012; 11:513–518.
    1. Orloff MJ, Vaida F, Isenberg JI, et al. Child-Turcotte score versus MELD for prognosis in a randomized controlled trial of emergency treatment of bleeding esophageal varices in cirrhosis. J Surg Res 2012; 178:139–146.
    1. Papatheodoridis GV, Cholongitas E, Dimitriadou E, et al. MELD vs Child-Pugh and creatinine-modified Child-Pugh score for predicting survival in patients with decompensated cirrhosis. World J Gastroenterol 2005; 11:3099–3104.
    1. Park SH, Suk KT, Kim EJ, et al. Prognostic significance of the hemodynamic and clinical staging in the prediction of mortality in patients with chronic liver disease. Hepatology (Baltimore, MD) 2014; 60:1182A–1183A.
    1. Peng Y, Qi X, Dai J, et al. Child-Pugh versus MELD score for predicting the in-hospital mortality of acute upper gastrointestinal bleeding in liver cirrhosis. Int J Clin Exp Med 2015; 8:751–757.
    1. Perkins L, Jeffries M, Patel T. Utility of preoperative scores for predicting morbidity after cholecystectomy in patients with cirrhosis. Clin Gastroenterol Hepatol 2004; 2:1123–1128.
    1. Radha Krishna Y, Saraswat VA, Das K, et al. Clinical features and predictors of outcome in acute hepatitis A and hepatitis E virus hepatitis on cirrhosis. Liver Int 2009; 29:392–398.
    1. Rahimi-Dehkordi N, Nourijelyani K, Nasiri-Tousi M, et al. Model for End stage Liver Disease (MELD) and Child-Turcotte- Pugh (CTP) scores: Ability to predict mortality and removal from liver transplantation waiting list due to poor medical conditions. Arch Iran Med 2014; 17:118–121.
    1. Raszeja-Wyszomirska J, Wasilewicz MP, Wunsch E, et al. Assessment of a modified Child-Pugh-Turcotte score to predict early mortality after liver transplantation. Transpl Proc 2009; 41:3114–3116.
    1. Reverter E, Tandon P, Augustin S, et al. A MELD-based model to determine risk of mortality among patients with acute variceal bleeding. Gastroenterology 2014; 146:412–431.e3.
    1. Ripoll C, Groszmann R, Garcia-Tsao G, et al. Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis. Gastroenterology 2007; 133:481–488.
    1. Salerno F, Merli M, Cazzaniga M, et al. MELD score is better than Child-Pugh score in predicting 3-month survival of patients undergoing transjugular intrahepatic portosystemic shunt. J Hepatol 2002; 36:494–500.
    1. Schepke M, Roth F, Fimmers R, et al. Comparison of MELD, Child-Pugh, and Emory model for the prediction of survival in patients undergoing transjugular intrahepatic portosystemic shunting. Am J Gastroenterol 2003; 98:1167–1174.
    1. Seamon MJ, Franco MJ, Stawicki SP, et al. Do chronic liver disease scoring systems predict outcomes in trauma patients with liver disease? A comparison of MELD and CTP. J Trauma 2010; 69:568–573.
    1. Sempere L, Palazon JM, Sanchez-Paya J, et al. Assessing the short- and long-term prognosis of patients with cirrhosis and acute variceal bleeding. Rev Esp Enferm Dig 2009; 101:236–248.
    1. Serra MA, Puchades MJ, Rodriguez F, et al. Clinical value of increased serum creatinine concentration as predictor of short-term outcome in decompensated cirrhosis. Scand J Gastroenterol 2004; 39:1149–1153.
    1. Serste T, Gustot T, Rautou PE, et al. Severe hyponatremia is a better predictor of mortality than MELDNa in patients with cirrhosis and refractory ascites. J Hepatol 2012; 57:274–280.
    1. Shaikh S, Ghani H, Memon S, et al. MELD era: is this time to replace the original Child-Pugh score in patients with decompensated cirrhosis of liver. J Coll Physicians Surg 2010; 20:432–435.
    1. Sharma P, Sharma BC. Predictors of minimal hepatic encephalopathy in patients with cirrhosis. Saudi J Gastroenterol 2010; 16:181–187.
    1. Song CS, Yoon MY, Kim HJ, et al. [Usefulness of model for end-stage liver disease score for predicting mortality after intra-abdominal surgery in patients with liver cirrhosis in a single hospital]. Korean J Gastroenterol 2011; 57:340–345.
    1. Song DS, Kim DJ, Kim TY, et al. The usefulness of prognostic factors of acute-on chronic liver failure in patients with liver cirrhosis: a multicenter, retrospective cohort study in Korea (KACLiF Study). Hepatology (Baltimore, MD) 2014; 60:552A–553A.
    1. Stewart CA, Malinchoc M, Kim WR, et al. Hepatic encephalopathy as a predictor of survival in patients with end-stage liver disease. Liver Transpl 2007; 13:1366–1371.
    1. Su CW, Chan CC, Hung HH, et al. Predictive value of aspartate aminotransferase to alanine aminotransferase ratio for hepatic fibrosis and clinical adverse outcomes in patients with primary biliary cirrhosis. J Clin Gastroenterol 2009; 43:876–883.
    1. Suk KT, Bang CS, Lee YS, et al. Diagnostic significance of hepatic venous pressure gradient in the prediction of hepatocellular carcinoma. J Hepatol 2014; 60:S261.
    1. Suman A, Barnes DS, Zein NN, et al. Predicting outcome after cardiac surgery in patients with cirrhosis: a comparison of Child-Pugh and MELD scores. Clin Gastroenterol Hepatol 2004; 2:719–723.
    1. Tacke F, Fiedler K, Trautwein C. A simple clinical score predicts high risk for upper gastrointestinal hemorrhages from varices in patients with chronic liver disease. Scand J Gastroenterol 2007; 42:374–382.
    1. Takaya H, Uemura M, Fujimura Y, et al. ADAMTS13 activity may predict the cumulative survival of patients with liver cirrhosis in comparison with the Child-Turcotte-Pugh score and the Model for End-Stage Liver Disease score. Hepatol Res 2012; 42:459–472.
    1. Tas A, Akbal E, Beyazit Y, et al. Serum lactate level predict mortality in elderly patients with cirrhosis. Wien Klin Wochenschr 2012; 124:520–525.
    1. Tas A, Koklu S, Beyazit Y, et al. Thyroid hormone levels predict mortality in intensive care patients with cirrhosis. Am J Med Sci 2012; 344:175–179.
    1. Teng W, Chen WT, Ho YP, et al. Predictors of mortality within 6 weeks after treatment of gastric variceal bleeding in cirrhotic patients. Medicine (United States) 2014; 93:e321.
    1. Theocharidou E, Pieri G, Mohammad AO, et al. The Royal Free Hospital score: a calibrated prognostic model for patients with cirrhosis admitted to intensive care unit. Comparison with current models and CLIF-SOFA score. Am J Gastroenterol 2014; 109:554–562.
    1. Thielmann M, Mechmet A, Neuhauser M, et al. Risk prediction and outcomes in patients with liver cirrhosis undergoing open-heart surgery. Eur J Cardiothorac Surg 2010; 38:592–599.
    1. Tu KH, Jenq CC, Tsai MH, et al. Outcome scoring systems for short-term prognosis in critically ill cirrhotic patients. Shock (Augusta, GA) 2011; 36:445–450.
    1. Tzeng WS, Wu RH, Lin CY, et al. Prediction of mortality after emergent transjugular intrahepatic portosystemic shunt placement: use of APACHE II, Child-Pugh and MELD scores in Asian patients with refractory variceal hemorrhage. Korean J Radiol 2009; 10:481–489.
    1. Vanhuyse F, Maureira P, Portocarrero E, et al. Cardiac surgery in cirrhotic patients: results and evaluation of risk factors. Eur J Cardiothorac Surg 2012; 42:293–299.
    1. Velayutham V, Sathyanesan J, Krishnan A, et al. Variation of meld vs child pugh score for predicting survival in patients in waiting list for liver transplantation. Liver Transpl 2012; 18:S220.
    1. Viasus D, Garcia-Vidal C, Castellote J, et al. Community-acquired pneumonia in patients with liver cirrhosis: clinical features, outcomes, and usefulness of severity scores. Medicine 2011; 90:110–118.
    1. Wang J, Wang AJ, Li BM, et al. MELD-Na: effective in predicting rebleeding in cirrhosis after cessation of esophageal variceal hemorrhage by endoscopic therapy. J Clin Gastroenterol 2014; 48:870–877.
    1. Wiesner R, Edwards E, Freeman R, et al. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology 2003; 124:91–96.
    1. Wu SJ, Yan HD, Zheng ZX, et al. Establishment and validation of ALPH-Q score to predict mortality risk in patients with acute-on-chronic hepatitis B liver failure: a prospective cohort study. Medicine 2015; 94:e403.
    1. Xie YD, Feng B, Gao Y, et al. Characteristics of alcoholic liver disease and predictive factors for mortality of patients with alcoholic cirrhosis. Hepatobiliary Pancreat Dis Int 2013; 12:594–601.
    1. Xiong WJ, Liu F, Zhao ZX, et al. Application of an end-stage liver disease model in prediction of prognosis in patients with liver cirrhosis. World Chin J Digestol 2004; 12:1159–1162.
    1. Zapata R, Innocenti F, Sanhueza E, et al. Predictive models in cirrhosis: correlation with the final results and costs of liver transplantation in Chile. Transpl Proc 2004; 36:1671–1672.
    1. Zhang F, Zhuge Y, Zou X, et al. Different scoring systems in predicting survival in Chinese patients with liver cirrhosis undergoing transjugular intrahepatic portosystemic shunt. Eur J Gastroenterol Hepatol 2014; 26:853–860.
    1. Zhang J, Lu F, Ouyang C, et al. [Respective analysis of dead patients with cirrhosis by Child-Pugh score and model of end-stage liver disease score]. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2012; 37:1021–1026.
    1. Zhang J, Ye L, Zhang J, et al. MELD scores and Child-Pugh classifications predict the outcomes of ERCP in cirrhotic patients with choledocholithiasis: a retrospective cohort study. Medicine 2015; 94:e433.
    1. Zhang JY, Zhang FK, Wang BE, et al. [The prognostic value of end-stage liver disease model in liver cirrhosis]. Zhonghua Nei Ke Za Zhi 2005; 44:822–824.
    1. Zhang QB, Chen YT, Lian GD, et al. A combination of models for end-stage liver disease and cirrhosis-related complications to predict the prognosis of liver cirrhosis. Clin Res Hepatol Gastroenterol 2012; 36:583–591.
    1. Zheng MH, Shi KQ, Fan YC, et al. A model to determine 3-month mortality risk in patients with acute-on-chronic hepatitis B liver failure. Clin Gastroenterol Hepatol 2011; 9:351–356.e3.
    1. Cholongitas E, Papatheodoridis GV, Vangeli M, et al. Systematic review: The model for end-stage liver disease – should it replace Child-Pugh's classification for assessing prognosis in cirrhosis? Aliment Pharmacol Ther 2005; 22:1079–1089.
    1. Durand F, Valla D. Assessment of the prognosis of cirrhosis: Child-Pugh versus MELD. J Hepatol 2005; 42 (SUPPL. 1):S100–S107.
    1. Durand F, Valla D. Assessment of prognosis of cirrhosis. Semin Liver Dis 2008; 28:110–122.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다