MELD score is better than Child-Pugh score in predicting 3-month survival of patients undergoing transjugular intrahepatic portosystemic shunt

Francesco Salerno, Manuela Merli, Massimo Cazzaniga, Valentina Valeriano, Plinio Rossi, Andrea Lovaria, Daniele Meregaglia, Antonio Nicolini, Lorenzo Lubatti, Oliviero Riggio

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aims: Patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) are at risk of early death due to end-stage liver failure. The aim of this study was to compare model of end-stage liver disease (MELD) and Child-Pugh scores as predictors of survival after TIPS. Methods: We studied 140 cirrhotic patients treated with elective TIPS. Concordance (c)-statistic was used to assess the ability of MELD or Child-Pugh scores to predict 3-month survival. The prediction of overall survivals was estimated by comparing actuarial curves of subgroups of patients stratified according to either Child-Pugh scores or MELD risk scores. Results: During a median follow-up of 23.7 months, 55 patients died, 14 underwent liver transplantation and seven were lost to follow-up. For 3-month survival, the discrimination power of MELD score was superior to Child-Pugh score (0.84 vs. 0.70, z = 2.07; P = 0.038). Unlike Pugh score, MELD score identified two subgroups of Child C patients with different overall survivals (P = 0.027). The comparison between observed and predicted survivals showed that MELD score overrates death risk. Conclusions: MELD score is superior to Child-Pugh score as predictor of short-term outcome after TIPS. Its accuracy, however, decreases for long-term predictions.

Original languageEnglish
Pages (from-to)494-500
Number of pages7
JournalJournal of Hepatology
Volume36
Issue number4
DOIs
Publication statusPublished - 2002

Keywords

  • Child-Pugh score
  • Cirrhosis
  • Survival
  • Transjugular intrahepatic portosystemic shunt

ASJC Scopus subject areas

  • Gastroenterology

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