Evaluation of the model for end-stage liver disease and Child-Turcotte-Pugh score on the surgical prognosis in patients with liver cirrhosis / 中国医师进修杂志

ABSTRACT

Objective To investigate the value of the model for end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) score in predicting the prognosis of patients with liver cirrhosis.Methods Seventy patients with liver cirrhosis were selected.The MELD and CTP score before surgery was calculated and was analyzed the correlation between the two models was analyzed.The prognosis ability by the area under the receiver operating characteristic (ROC) curve was evaluated.Results Twenty three cases (32.9％,23/70) appeared post operative serious complication.The scores of MELD and CTP in complication group (23 cases) was (19.58 ±5.90),(8.84 ± 1.87) scores,the scores of MELD and CTP in without complication group (47 cases) was ( 12.27 ± 2.94),(6.10 ± 1.12) scores,there were significant differences between two groups (P ＜ 0.01 ).According to the MELD score,70 patients was divided into ＜ 14 scores group(30 cases),14 - 23 scores group(28 cases),＞ 23 scores group( 12 cases),the rate of complication was 10.0％(3/30),35.7％( 10/28 ) and 83.3％(10/12),there were significant differences among three groups(P＜ 0.05).According to the CTP score,70 patients were divided into A grade(29 cases),B grade (25 cases) and C grade( 16 cases),the rate of complication was 10.3％ ( 3/29 ),36.0％ (9/25) and 68.8％ ( 11/16 ),there were significant differences among three groups (P ＜ 0.05 ).The results of Pearson correlation analysis showed that the MELD score and CTP score had significant correlation (r =0.874,P ＜ 0.01 ).The area under the ROC curve of the MELD score and CTP score in prognosis the perioperative complication was 0.877 (95％ CI0.84 - 0.95 ) and 0.852 (95％ CI0.83 - 0.94),there was no significant difference ( U =0.157,P ＞ 0.05 ).Conclusion Both MELD and CTP score can accurately predict the short term prognosis of patients with liver cirrhosis.