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Model for end‐stage liver disease combined with serum prealbumin to predict the prognosis of patients with decompensated liver cirrhosis
Author(s) -
LIU Fei,
CAI Ling Yan,
ZHONG Lan,
CHEN Chi,
XU Fei,
ZHAO Zhong Xin,
CHEN Xi Mei
Publication year - 2010
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/j.1751-2980.2010.00465.x
Subject(s) - medicine , model for end stage liver disease , gastroenterology , cirrhosis , liver disease , proportional hazards model , survival analysis , stage (stratigraphy) , liver transplantation , transplantation , paleontology , biology
OBJECTIVE: To evaluate the prognostic value of model for end‐stage liver disease (MELD) combined with serum prealbumin (PA) in patients with decompensated liver cirrhosis. METHODS: A total of 252 patients were enrolled in the study and followed 1 year. PA was measured and MELD score was calculated on the first day of admission. Analysis of variance ( anova ) was used to assess correlation between PA level and MELD score. Multivariable Cox proportional hazards model was used to screen the prognosis related factors. Kaplan–Meier survival curves were drawn. RESULTS: Of the 252 patients, 28 died within 3 months, 58 within 6 months and 91 within 1 year. Serum PA level in dead patients was significantly lower than that in survival patients ( P < 0.005) and decreasing with increasing of MELD score. Cox analysis showed that MELD score > 18 (RR = 2.749) and PA < 70 mg/L (RR = 2.412) were independent prognosis risk factors. The risk ratio of MELD score combined with PA level (1.854, P < 0.01) was higher than that of MELD score alone (1.054, P < 0.05). Kaplan–Meier survival curve analysis showed that MELD score ≤ 18 combined with PA ≥ 70 mg/L could clearly discriminate patients who would survive or die within 6 month and 1 year follow up. CONCLUSION: MELD score ≤ 18 combined with PA ≥ 70 mg/L could predict the 6‐month and 1‐year prognosis of patients with decompensated liver cirrhosis, and was superior to that of MELD score alone.