The refit model for end-stage liver disease-Na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascites
Background/AimsThe modification of the Model for End-Stage Liver Disease (MELD) scoring system (Refit MELD) and the modification of MELD-Na (Refit MELDNa), which optimized the MELD coefficients, were published in 2011. We aimed to validate the superiority of the Refit MELDNa over the Refit MELD for...
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doaj-98492b022ebc48478820d87c174d228e2020-11-25T01:50:14ZengKorean Association for the Study of the LiverClinical and Molecular Hepatology2287-27282287-285X2014-03-01201475510.3350/cmh.2014.20.1.471114The refit model for end-stage liver disease-Na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascitesJun Jae Kim0Jeong Han Kim1Ja Kyung Koo2Yun Jung Choi3Soon Young Ko4Won Hyeok Choe5So Young Kwon6Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.Background/AimsThe modification of the Model for End-Stage Liver Disease (MELD) scoring system (Refit MELD) and the modification of MELD-Na (Refit MELDNa), which optimized the MELD coefficients, were published in 2011. We aimed to validate the superiority of the Refit MELDNa over the Refit MELD for the prediction of 3-month mortality in Korean patients with cirrhosis and ascites.MethodsWe reviewed the medical records of patients admitted with hepatic cirrhosis and ascites to the Konkuk University Hospital between January 2006 and December 2011. The Refit MELD and Refit MELDNa were compared using the predictive value of the 3-month mortality, as assessed by the Child-Pugh score.ResultsIn total, 530 patients were enrolled, 87 of whom died within 3 months. Alcohol was the most common etiology of their cirrhosis (n=271, 51.1%), and the most common cause of death was variceal bleeding (n=20, 23%). The areas under the receiver operating curve (AUROCs) for the Child-Pugh, Refit MELD, and Refit MELDNa scores were 0.754, 0.791, and 0.764 respectively; the corresponding values when the analysis was performed only in patients with persistent ascites (n=115) were 0.725, 0.804, and 0.796, respectively. The significant difference found among the Child-Pugh, Refit MELD, and Refit MELDNa scores was between the Child-Pugh score and Refit MELD in patients with persistent ascites (P=0.039).ConclusionsRefit MELD and Refit MELDNa exhibited good predictability for 3-month mortality in patients with cirrhosis and ascites. However, Refit MELDNa was not found to be a better predictor than Refit MELD, despite the known relationship between hyponatremia and mortality in cirrhotic patients with ascites.http://e-cmh.org/upload/pdf/cmh-20-47.pdfStage Liver DiseaseLiver CirrhosisAscitesMortalityHyponatremia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jun Jae Kim Jeong Han Kim Ja Kyung Koo Yun Jung Choi Soon Young Ko Won Hyeok Choe So Young Kwon |
spellingShingle |
Jun Jae Kim Jeong Han Kim Ja Kyung Koo Yun Jung Choi Soon Young Ko Won Hyeok Choe So Young Kwon The refit model for end-stage liver disease-Na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascites Clinical and Molecular Hepatology Stage Liver Disease Liver Cirrhosis Ascites Mortality Hyponatremia |
author_facet |
Jun Jae Kim Jeong Han Kim Ja Kyung Koo Yun Jung Choi Soon Young Ko Won Hyeok Choe So Young Kwon |
author_sort |
Jun Jae Kim |
title |
The refit model for end-stage liver disease-Na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascites |
title_short |
The refit model for end-stage liver disease-Na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascites |
title_full |
The refit model for end-stage liver disease-Na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascites |
title_fullStr |
The refit model for end-stage liver disease-Na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascites |
title_full_unstemmed |
The refit model for end-stage liver disease-Na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascites |
title_sort |
refit model for end-stage liver disease-na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascites |
publisher |
Korean Association for the Study of the Liver |
series |
Clinical and Molecular Hepatology |
issn |
2287-2728 2287-285X |
publishDate |
2014-03-01 |
description |
Background/AimsThe modification of the Model for End-Stage Liver Disease (MELD) scoring system (Refit MELD) and the modification of MELD-Na (Refit MELDNa), which optimized the MELD coefficients, were published in 2011. We aimed to validate the superiority of the Refit MELDNa over the Refit MELD for the prediction of 3-month mortality in Korean patients with cirrhosis and ascites.MethodsWe reviewed the medical records of patients admitted with hepatic cirrhosis and ascites to the Konkuk University Hospital between January 2006 and December 2011. The Refit MELD and Refit MELDNa were compared using the predictive value of the 3-month mortality, as assessed by the Child-Pugh score.ResultsIn total, 530 patients were enrolled, 87 of whom died within 3 months. Alcohol was the most common etiology of their cirrhosis (n=271, 51.1%), and the most common cause of death was variceal bleeding (n=20, 23%). The areas under the receiver operating curve (AUROCs) for the Child-Pugh, Refit MELD, and Refit MELDNa scores were 0.754, 0.791, and 0.764 respectively; the corresponding values when the analysis was performed only in patients with persistent ascites (n=115) were 0.725, 0.804, and 0.796, respectively. The significant difference found among the Child-Pugh, Refit MELD, and Refit MELDNa scores was between the Child-Pugh score and Refit MELD in patients with persistent ascites (P=0.039).ConclusionsRefit MELD and Refit MELDNa exhibited good predictability for 3-month mortality in patients with cirrhosis and ascites. However, Refit MELDNa was not found to be a better predictor than Refit MELD, despite the known relationship between hyponatremia and mortality in cirrhotic patients with ascites. |
topic |
Stage Liver Disease Liver Cirrhosis Ascites Mortality Hyponatremia |
url |
http://e-cmh.org/upload/pdf/cmh-20-47.pdf |
work_keys_str_mv |
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