Jeong Eun Mi, Hwang Seong Gyu, Park Hong Hoon, Park Ji Han, Kim Hyung Tae, Oh Seong Wook, Kho Kwang Hyun, Hong Sung Pyo, Park Phil Won, Rim Gyu Sung, Kim Se Hyun
Department of Internal Medicine, Pochon CHA University College of Medicine, Sungnam, Korea.
Taehan Kan Hakhoe Chi. 2003 Jun;9(2):98-106.
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.
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.
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.
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.
背景/目的：终末期肝病模型（MELD）由血清胆红素和肌酐水平、凝血酶原时间的国际标准化比值（INR）以及肝病病因组成。MELD评分是死亡风险的可靠衡量指标，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数的有效性。
我们调查了1995年1月至2001年5月间住院的379例肝硬化患者。我们回顾性查阅医院记录以核实肝硬化诊断，并收集有关患者人口统计学数据、门静脉高压并发症和实验室数据的确切信息。使用一致性c统计量检验根据肝硬化患者死亡风险对其进行分类的能力。
MELD评分在预测3个月内死亡方面表现良好，有病因时c统计量为0.73，无病因时为0.71。肝硬化患者3个月生存的显著临床和实验室变量是血清胆红素、腹水和肝性脑病。将门静脉高压并发症纳入MELD评分并未提高MELD评分的准确性。
MELD评分是终末期肝病患者有用的疾病严重程度指数，可在广泛的肝病严重程度和不同病因范围内提供可靠的短期生存衡量指标。
