肝硬化患者CTP评分与MELD评分的死亡率分析

Eun Mi Jeong, Seong Gyu Hwang, Hong Hoon Park, Ji Han Park, Hyung Tae Kim, Seong Wook Oh, Kwang Hyun Kho, Sung Pyo Hong, Phil Won Park, Gyu Sung Rim, Se Hyun Kim
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引用次数: 0

摘要

背景/目的:终末期肝病(MELD)模型由血清胆红素和肌酐水平、凝血酶原时间的国际标准化比率(INR)和肝病病因组成。MELD评分是一种可靠的死亡风险测量方法,适用于终末期肝病患者的疾病严重程度指数。我们检验了MELD作为终末期肝病患者疾病严重程度指标的有效性。方法:对1995年1月~ 2001年5月住院的肝硬化患者379例进行调查。我们回顾性地回顾了医院记录,以验证肝硬化的诊断,并收集准确的患者信息,包括他们的人口统计数据、门脉高压并发症和实验室数据。根据死亡风险对肝硬化患者进行分类的能力采用一致性c统计量进行检验。结果:MELD评分能很好地预测3个月内的死亡,有病因的c统计量为0.73,无病因的c统计量为0.71。影响肝硬化患者3个月生存的重要临床和实验室变量是血清胆红素、腹水和肝性脑病。在MELD评分中加入门静脉高压并发症并没有提高MELD评分的准确性。结论:MELD评分对于终末期肝病患者来说是一个有用的疾病严重程度指标,在广泛的肝病严重程度和多种病因的情况下,提供了可靠的短期生存指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[The anaylsis of mortality rate according to CTP score and MELD score in patients with liver cirrhosis].

Background/aims: The Model for End-Stage Liver Disease (MELD) consists of serum bilirubin and creatinine levels, International Normalized Ratio (INR) for prothrombin time, and etiology of liver disease. The MELD score is a reliable measurement of mortality risk and is suitable for a disease severity index in patients with end-stage liver disease. We examined the validity of the MELD as a disease severity index for patients with end-stage liver disease.

Methods: We investigated the 379 patients with liver cirrhosis hospitalized between January 1995 and May 2001. We retrospectively reviewed the hospital records to verify the diagnosis of cirrhosis and to collect exact patient information about their demographic data, portal hypertensive complications and laboratory data. The ability to classify patients with liver cirrhosis according to their risk of death was examined using the concordance c-statistic.

Results: The MELD score performed well in predicting death within 3 months with a c-statistic of 0.73 with etiology and 0.71 without etiology. The significant clinical, laboratory variables on 3 month survival in patients with liver cirrhosis are serum bilirubin, ascites and hepatic encephalopathy. The addition of portal hypertensive complications to the MELD score did not improve the accuracy of the MELD score.

Conclusions: The MELD score is a useful disease severity index for the patients with end-stage liver disease and provides reliable measurement of short term survival over a wide range of liver disease severity and diverse etiology.

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