Comparison between Different Risk Scores in Predicting Hospital Mortality for Patients with Decompensated Liver Cirrhosis: A Single Center Study
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- Category: Vol. 88, June 2020
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Comparison between Different Risk Scores in Predicting Hospital Mortality for Patients with Decompensated Liver Cirrhosis: A Single Center Study, MAHMOUD H. ALLAM, MOHAMED A.S. KOHLA and WESAM S. MORAD
Abstract
Background: Predicting prognosis of patients with decom-pensated liver cirrhosis remains an important issue. Aim of Study: This study aimed to evaluate the predictive value of different patients' characteristics and risk scores as regard patients' outcome (death or survival). Patients and Methods: 672 patients with different com-plications of cirrhosis (gastrointestinal bleeding, hepatic encephalopathy, SBP, HRS and ascites) who were admitted to the National Liver Institute Hospital between 2015 and 2018 were included in this study. On admission to the hospital, assessment of patients by routine laboratory work-up (liver and kidney function tests and complete blood count), ultrasound of the abdomen, upper endoscopy for those with bleeding and ascitic fluid sampling for those with ascites. MELD, MELD-Na, CTP, ALBI and PALBI grades were calculated for all patients. At the end of hospitalization, patients outcomes were stratified as survived or died. Patients clinical and laboratory parameters were correlated with hospital mortality. Receiver Operating Curves (ROC) for risk scores were plotted to discriminate the predictive power of risk scores versus mor-tality. Results: The overall hospital mortality was 27.1%. Uni-variate analysis revealed age, total and direct bilirubin, albumin, transaminases, alkaline phosphatase, INR, serum creatinine, BUN, serum sodium and white cells count as significant, while multivariate analysis concluded age, total bilirubin, serum creatinine, Blood Urea Nitrogen (BUN), serum sodium (Na), INR and white blood cells count significance with hospital mortality, (p<0.05). The area under receiver operating curve for MELD-Na was (0.85), MELD score (0.84), CTP score (0.82), AlBI grade (0.75) and PALBI grade (0.75), p<0.001. Conclusion: MELD-Na and MELD scores are good pre-dictors for prognosis of patients with decompensated liver cirrhosis. But, ALBI and PALBI grade are promising scores which needs more validation.