Diagnostic and Prognostic Utility of Model for End-Stage Liver Disease (MELD) and MELD-Na in Short Term Three Month Mortality of Patients with Chronic Liver Disease.

Abstract

Background: A late stage of progressive hepatic fibrosis known as cirrhosis is characterized by the formation of regenerative nodules and distortion of the liver's architecture. In its advanced stages, it is commonly thought to be irreversible, making liver transplantation the only option for treatment. This study aimed to evaluate the MELD and MELD-Na in relation to the short-term mortality of patients with liver cirrhosis.

Material & Method: This prospective observational study was conducted in patients who were hospitalized with complications due to chronic liver disease at Yenepoya Medical College, Mangalore. Patients aged more than 18 years of age with chronic liver disease were included. Patients diagnosed with hepatocellular carcinoma, SIADH, on antiviral treatment, congestive cardiac failure, patients on thiazide diuretics and pancreatic injuries were excluded from study. Patients with clinical and imaging features consistent with a diagnosis of chronic liver disease and the blood parameters were measured and the Child-Pugh score, MELD score and MELD-Na score was measured. The data were entered in MS Excel spreadsheet and analysed using SPSS v21 operating on windows 10.

Result: A total of sixty four patients who were enrolled had a mean age of 49.68±9.89yrs. Among them 62 were males. There was a significantly higher mean level of renal parameters, Child-Pugh score, MELD score, MELD-Na and MELD plus score in patients who died, when compared to the patients who survived (p<0.05). This study also showed significant positive strength of association of Child-Pugh score with MELD score (r=0.669), MELD Na score (r=0.718).

Conclusion: Study documented the utility of MELD and MELD-Na in predicting the mortality among patients with liver cirrhosis.

Keywords: Cirrhosis, MELD, MELD-Na score, Mortality, Prediction