Value of MELD combined with serum sodium concentration in predicting the short-term outcome of patients with HBV-related acute-on-chronic liver failure in China: A meta-analysis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the value of MELD combined with serum sodium concentration (MELD-Na) in predicting the short-term outcome of patients with HBV-related acute-on-chronic liver failure (ACLF) in China. MethodsPubMed, Embase, CNKI, VIP, and Wanfang Data were searched for related articles in English and Chinese published from January 2006 to March 2018. The second version of Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used to evaluate the quality of each article. The presence or absence of threshold effect was examined. According to the presence or absence of heterogeneity, a random effect model or a fixed effect model was used for pooling sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR). The receiver operating characteristic (ROC) curve was plotted and the area under the ROC curve (AUC) was calculated. The Deek’s funnel plot asymmetry test was used to investigate the presence or absence of publication bias. ResultsA total of eight studies were included, with a total of 1386 patients, among whom there were 1173 (84.6%) male patients. The mean age of the patients included in these studies ranged from 41.3 to 46.9 years. The tests for heterogeneity showed significant heterogeneity between studies and a random effect model was used for pooling. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and DOR were 0.67 (95% confidence interval ［CI］ 0.59-0.75), 0.77 (95%CI 0.63-0.87), 2.89 (95%CI 1.84-4.54), 0.43 (95%CI 0.35-0.52), and 7.32 (95%CI 4.33-12.40), respectively. The AUC was 0.75 (95CI 0.72-0.79). The Deek’s funnel plot asymmetry test showed no significant publication bias. ConclusionMELD-Na score has a certain value in predicting the short-term outcome of patients with HBV-related ACLF in China.