JOURNAL OF PRACTICAL HEPATOLOGY ›› 2018, Vol. 21 ›› Issue (3): 417-420.doi: 10.3969/j.issn.1672-5069.2018.03.025

• Hepatic failure • Previous Articles     Next Articles

Prediction of short-term survival by four scoring systems based on MELD in patients with acute-on-chronic hepatitis B-induced liver failure

Li Lei, Hu Hui, Zheng Xiaowei, et al   

  1. Department of Infectious Disease,Provincial Hospital,Hefei 230001,Anhui Province,China
  • Received:2017-11-11 Online:2018-05-10 Published:2018-05-25

Abstract: Objective To validate the prediction of short-term survival by four scoring systems based on models for end-stage liver disease(MELD) in patients with acute-on-chronic hepatitis B-induced liver failure (HBV-ACLF). Methods 67 patients with HBV-ACLF were enrolled in this study between April 2015 and October 2017. The clinical parameters were collected for calculation of MELD,iMELD,MELD-Na and MESO scores,respectively. The predictive efficacy on forecasting survival of patients with HBV-ACLF by the four scoring systems was analyzed by receiver operating characteristic curve(ROC) supported by MedCalc15.8 software. Results 45(67.2%) out of 67 patients with HBV-ACLF died within 12 weeks;the scores of MELD,iMELD,MELD-Na and MESO models at presentation in survival group were (22.12±3.24),(41.59±5.30),(22.55±4.07) and (1.64±0.24),much lower than 【(30.47±9.01),(51.88±11.09),(32.35±11.58) and (2.28±0.70),respectively,P<0.01】 in the dead group;the area under the ROC curve (AUC) in forecasting the survival of patients with HBV-ACLF by the four models were 0.814,0.802,0.806 and 0.817 respectively,the cut-off-values were 22.70,47.76,22.16 and 1.69,and the Jordan index were 0.5040,0.5535,0.4808 and 0.4818,respectively,suggesting no significant differences between them(P>0.05). Conclusion The four scoring systems base on MELD have good predictive efficacy on forecasting 12 weeks’ survival in patients with HBV-ACLF,which hints they might be applied in clinical practice.

Key words: Acute-on-chronic liver failure, Hepatitis B, Models for end-stage liver disease, Prognosis