To Compare between CTP, MELD, MELD-Na, MELD + HDLc, RDW, and RDW to Platelet Ratio as a Predictor of Short-term Mortality in Cirrhosis of Liver.

Abstract

Background: Liver cirrhosis indicates inflammation, necrosis, as well as fibrosis, resulting in progressively decreasing liver function. As the disease advances from a compensated to a decompensated stage, patients experience severe clinical complications, that result in elevated mortality, as well as morbidity, rates. Accurate predicting short-term mortality is essential for making clinical decisions, particularly when it comes to liver transplantation (LT). Several scores, encompassing model for end-stage liver disease (MELD), Child-Turcotte-Pugh (CTP), as well as their variants, along with specific biomarkers such as red cell distribution width (RDW) alongside RDW to platelet ratio (RPR), have been proposed for assessing these patients' prognosis. However, comparative effectiveness of these scoring systems in predicting outcomes remains underexplored.

Methods: This study involved a cohort of participants diagnosed with cirrhosis, who were evaluated to identify the most reliable predictors of 30-day mortality. The study compared the efficacy of multiple scoring systems, including CTP, MELD, model for end-stage liver disease-sodium (MELD-Na), model for end-stage liver disease-high-density lipoprotein cholesterol (MELD-HDLc), RDW, and RPR, by analyzing their correlation with patient outcomes. Data were collected on demographic profiles, clinical findings, and laboratory markers to calculate these scores and assess their predictive accuracy.

Results: The study found that among the various scores, the MELD as well as MELD-Na scores demonstrated the highest accuracy predicting 30-day mortality in liver cirrhosis patients. Alcohol emerged as the predominant etiology of cirrhosis, and there was a significant male predominance in the cohort. The results were consistent with existing literature, confirming the reliability of MELD alongside MELD-Na as stronger prognostic tools compared to the CTP score and other markers.

Conclusion: MELD along with MELD-Na scores constitute reliable indicators of mortality over the short term in individuals with cirrhosis and should be preferred in practice for assessing the need for LT and other critical interventions. These findings underscore the importance of using evidence-based scoring systems to improve patient management and outcomes in liver cirrhosis, a condition with a high global mortality burden.