Aim To create a predictive score based on functional parameters of the liver and determine its prognostic value in survival of patients with decompensated cirrhosis. Methods Retrospective observational study included 91 consecutive patients with decompensated cirrhosis. Functional parameters (bilirubin, AST – aspartate aminotransferase, ALT – alanine aminotransferase, ALP – alkaline phosphatase, GGT – gammaglutamyltranferase, albumin, prothrombin time, platelet count, haematocrit and creatinine), Child-Pugh (CP) and Model of EndStage Liver Disease (MELD) scores have been measured at first hospitalization and at every exacerbation episode over follow-up period of 24 months. Results Using Cox regression analysis, we found that age (OR=1.206; p=0.03; 95% CI=1.019-1.428), serum bilirubin (OR=1.017; p=0.003; 95% CI=1.006-1.029), INR (International normalized ratio) (OR=6.262; p=0.002; 95% CI=1.924-20.378) and serum creatinine (OR=1.019; p=0.005; 95% CI=1.006- 1.032) had statistically strong association with the incidence of a six-month mortality. Age (OR=1.120; p=0.006; 95% CI=1.033- 1.214), serum bilirubin (OR=1.021; p=0.0001; 95% CI=1.010-1.032), GGT (OR=1.007; p=0.023; 95% CI=1.001-1.014), INR (OR=9.571; p=0.001; 95% CI=2.610-35.098), haematocrit (OR=0.695; p=0.001; 95% CI=0.559-0.864) and serum creatinine (OR=1.023; p=0.0001; 95% CI=1.011-1.035) showed an increased the risk for a 24-month lethal outcome. Predictive score derived from liver functional parameters, CP and MELD scores, each independently has shown a high degree of death prediction after 6 or 24 months in patients with end-stage liver disease. Conclusion Predictive score derived from liver functional parameters had a better prognostic value for short-term and long-term mortality comparing to MELD and Child-Pugh score.
Ravaioli F, Maria D, N, Marco D, Pivetti L, Casciola A, et al. From listing to recovery: a review of nutritional status assessment and management in liver transplant patients. Nutrients. 2023;2778–82.
2.
Kulkarni A, Reddy R, Sharma M, Iyengar S, Rambhatla A, Gv P. Healthcare utilization and outcomes of living donor liver transplantation for patients with APASL-defined acute-on-chronic liver failure. Hepatol Int. 2023;1–8.
3.
Tejedor-Tejada J, Garcia-Pajares F, Safadi R, Mauriz-Barreiro V, Molina E, Juan-Casamayor L. The impact of obesity on postoperative complications and shortterm survival after liver transplantation. Eur J Gastroenterol Hepatol. 2023;782–9.
4.
Chen. (7).
5.
Chen P, Chen B, Huang C, Jeng W, Hsieh Y, Teng W. Integrated model for end-stage liver disease may be superior to some other model for end-stage liver disease-based systems in addition to Child-Turcotte-Pugh and albumin-bilirubin scores in patients with hepatitis B virus-related liver cirrhosis and spontaneous bacterial peritonitis. Eur J Gastroenterol Hepatol. 2019;1256–63.
6.
Oikonomou T, Goulis L, Doumtsis P, Tzoumari T, Akriviadis E, Cholongitas E. ALBI and PALBI grades are associated with the outcome of patients with stable decompensated cirrhosis. Ann Hepatol. 2019;126–36.
7.
Xavier S, Vilas-Boas R, Carvalho P, Magalhães J, Marinho C, Cotter J. Assessment of prognostic performance of Albumin-Bilirubin, Child-Pugh, and Model for End-stage Liver Disease scores in patients with liver cirrhosis complicated with acute upper gastrointestinal bleeding. Eur J Gastroenterol Hepatol. 2018;652–8.
8.
Fragaki M, Sifaki-Pistolla D, Orfanoudaki E, Kouroumalis E. Comparative evaluation of ALBI, MELD, and Child-Pugh scores in prognosis of cirrhosis: is ALBI the new alternative? Ann Gastroenterol. 2019;626–32.
9.
Jeong J, Lee S, Shin S, Kim H, D. Factors predicting mortality in patients with alcoholic liver cirrhosis visiting the emergency department. Medicine (Baltimore). 2023;3307–14.
10.
Nie Y, Liu LX, Chen T, Zhang Y, Zhu X. Serum lactate level predicts 6-months mortality in patients with hepatitis B virus-related decompensated cirrhosis: a retrospective study. Epidemiol Infect. 2021;26–9.
11.
Sullivan M, Daher H, Rockey D. Normal or near normal aminotransferase levels in patients with alcoholic cirrhosis. Am J Med Sci. 2022;484–9.
12.
Reuben A. Child comes of age. Hepatology. 2002;244–5.
13.
Botta F, Giannini E, Romangoli P. MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study. Gut. 2003;134–9.
14.
Wang J, Zhang Z, Yan X, Li M, Xia J, Liu Y. Albumin-Bilirubin (ALBI) as an accurate and simple prognostic score for chronic hepatitis B-related liver cirrhosis Dig Liver. Dis. 2019;1172–8.
15.
Brunson H, Mcdonald M, Godfrey E, Keeling S, Cholankeril G, Kanwal F. Is liver transplant justified at any MELD score? 2023;680–92.
16.
Wiesner R, Edwards E, Freeman R. Model for endstage liver disease (MELD) and allocation of donor livers. Gastroenterology. 2003;91–6.
17.
Zhang T, Ye B, Shen J. Prognostic value of albuminrelated ratios in HBV-associated decompensated cirrhosis. J Clin Lab Anal. 2022;24338.
18.
Zhang W, Aryan M, Chen Z, Khan W, Thompson B, Kwenda E. Prognostic value of neutrophil-to-lymphocyte ratio in cirrhosis patients undergoing transjugular intrahepatic portosystemic shunt. Eur J Gastroenterol Hepatol. 2022;435–42.
19.
Granados V, Salazar-Quiñones M, Cheng-Zárate L, Malpica-Castillo A, Mercado J, Ticse R. Comparison of the prognostic value of mortality Child Pugh Score and forecasting models of chronic liver disease in patients with decompensated cirrhosis of the Hospital Nacional Cayetano Heredia. Rev Gastroenterol Peru. 2015;307–12.
20.
Wu S, Zheng Y, Tian Z, Chen M, Tan HZ, H. Scoring systems for prediction of mortality in decompensated liver cirrhosis: a meta-analysis of test accuracy. World J Clin Cases. 2018;995–1006.
21.
Zhou J, Li X, Wang M, Gu C, Liu J. Platelet-tomonocyte ratio as a novel promising agent for the prognosis of hepatitis B virus-associated decompensated cirrhosis. Can J Gastroenterol Hepatol. 2023;6646156.
22.
Semmler G, Yang Z, Fritz L, Köck F, Hofer B, Balcar L. Dynamics in liver stiffness measurements predict outcomes in advanced chronic liver disease. Gastroenterology. 2023;4768–74.
23.
Xu M, Wu Y, Li S, Geng N, Lu W, Duan W, et al. Application of different prognostic scores in liver transplantation decision-making for acute-on-chronic liver failure. Zhonghua Gan Zang Bing Za Zhi. 2023;574–81.
24.
Oikonomou T, Chrysavgis L, Kiapidou S, Adamantou M, Parastatidou D, Papatheodoridis G. Aspartate aminotransferase-to-platelet ratio index can predict the outcome in patients with stable decompensated cirrhosis. Ann Gastroenterol. 2023;442–8.
25.
Yousfi M, Douglas D, Harrison E. Dynamic changes in MELD score is important in predicting mortality for patients awaiting liver transplantation (LTX). Hepatology. 2001;254A.
26.
Papatheodoridis G, Cholongitas E, Dimitriadou E. MELD vs Child-Pugh and creatinine-modified Child-Pugh score for predicting survival in patients with decompensated cirrhosis. World J Gastroenterol. 2005;3099–104.
27.
Sumskiene J, Kupcinskas L, Pundzius J, Sumskas L. Prognostic factors for short and long-term survival in patients selected for liver transplantation. 2005;39–46.
28.
Sahani S, Das D. Neutrophil to lymphocyte ratio (NLR) and its correlation with Child Turcotte Pugh (CTP) Score in predicting severity of decompensated liver cirrhosis. J Assoc Physicians India. 2022;11–2.
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