Department of Internal Medicine, Konkuk University Medical Center, Seoul 05030, Republic of Korea.
Research Institute of Medical Science, Konkuk University School of Medicine, Seoul 05030, Republic of Korea.
Medicina (Kaunas). 2023 Mar 16;59(3):592. doi: 10.3390/medicina59030592.
: The Child-Pugh (CP) score and Model for End-Stage Liver Disease (MELD) are classical systems for predicting mortality in patients with liver cirrhosis (LC). The MELD-GFR assessment in liver disease-sodium (MELD-GRAIL-Na) was designed to better reflect renal function and, therefore, provide better mortality predictions. This study aimed to compare the prediction accuracy of MELD-GRAIL-Na compared to CP and MELD in predicting short-term (1- and 3-month) mortality in Korean patients. : Medical records of patients with LC admitted to the Konkuk University Hospital from 2015 to 2020 were retrospectively reviewed. Predictive values of the CP, MELD, and MELD-GRAIL-Na for 1-month and 3-month mortality were calculated using the area under the receiver operating curve (AUROC) and were compared using DeLong's test. : In total, 1249 patients were enrolled; 102 died within 1 month, and 146 within 3 months. AUROCs of CP, MELD, and MELD-GRAIL-Na were 0.831, 0.847, and 0.857 for 1-month mortality and 0.837, 0.827, and 0.835 for 3-month mortality, respectively, indicating no statistical significance. For patients with CP classes B and C, AUROCs of CP, MELD, and MELD-GRAIL-Na were 0.782, 0.809, and 0.825 for 1-month mortality and 0.775, 0.769, and 0.786 for 3-month mortality, respectively. There was a significant difference between CP and MELD-GRAIL-Na in predicting 1-month mortality ( = 0.0428) and between MELD and MELD-GRAIL-Na in predicting 1-month ( = 0.0493) and 3-month mortality ( = 0.0225). : Compared to CP and MELD, MELD-GRAIL-Na was found to be a better and more useful system for evaluating short-term (1- and 3-month) mortality in Korean patients with cirrhosis, especially those with advanced cirrhosis (CP class B and C).
：Child-Pugh（CP）评分和终末期肝病模型（MELD）是预测肝硬化患者死亡率的经典系统。为了更好地反映肾功能，从而提供更好的死亡率预测，设计了肝病-钠的MELD-GFR 评估（MELD-GRAIL-Na）。本研究旨在比较 MELD-GRAIL-Na 与 CP 和 MELD 在预测韩国患者短期（1 个月和 3 个月）死亡率方面的预测准确性。
：回顾性分析了 2015 年至 2020 年期间入住韩国孔敬大学医院的肝硬化患者的病历。使用接受者操作特征曲线（AUROC）下面积计算 CP、MELD 和 MELD-GRAIL-Na 对 1 个月和 3 个月死亡率的预测值，并使用 DeLong 检验进行比较。
：共纳入 1249 例患者；1 个月内 102 例死亡，3 个月内 146 例死亡。CP、MELD 和 MELD-GRAIL-Na 的 1 个月死亡率 AUROC 分别为 0.831、0.847 和 0.857，3 个月死亡率 AUROC 分别为 0.837、0.827 和 0.835，无统计学意义。对于 CP 分级为 B 和 C 的患者，CP、MELD 和 MELD-GRAIL-Na 的 1 个月死亡率 AUROC 分别为 0.782、0.809 和 0.825，3 个月死亡率 AUROC 分别为 0.775、0.769 和 0.786。CP 与 MELD-GRAIL-Na 在预测 1 个月死亡率方面存在显著差异（ = 0.0428），MELD 与 MELD-GRAIL-Na 在预测 1 个月（ = 0.0493）和 3 个月死亡率方面存在显著差异（ = 0.0225）。
：与 CP 和 MELD 相比，MELD-GRAIL-Na 被发现是评估韩国肝硬化患者短期（1 个月和 3 个月）死亡率的更好、更有用的系统，尤其是那些患有晚期肝硬化（CP 分级 B 和 C）的患者。
