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Prognostic performance of a series of model for end‑stage liver disease and respective Δ scores in patients with hepatitis B acute-on-chronic liver failure

  • Authors:
    • Yun-Hao Xun
    • Jun-Ping Shi
    • Chun-Qing Li
    • Dan Li
    • Wei-Zhen Shi
    • Qing-Chun Pan
    • Jian-Chun Guo
    • Guo-Qing Zang
  • View Affiliations / Copyright

    Affiliations: Department of Liver Diseases, Hangzhou Sixth People's Hospital/Xixi Hospital of Hangzhou, Zhejiang University of Traditional Chinese Medicine, Hangzhou, Zhejiang 310014, P.R. China, Department of Infectious Diseases, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, P.R. China
    Copyright: © Xun et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY_NC 3.0].
  • Pages: 1559-1568
    |
    Published online on: February 25, 2014
       https://doi.org/10.3892/mmr.2014.1983
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Abstract

The present study aimed to compare the short-term prognostic performance of a series of model for end-stage liver disease (MELD) and respective delta (∆) scores scoring systems in a population with acute-on-chronic hepatitis B liver failure (ACHBLF), and to investigate the potential effects from antivirals. A total of 77 patients with ACHBLF of mean age 46 years, 82% male, with 58.4% receiving antivirals, were recruited for this study. The ∆ scores for MELDs were defined as the changes one week after admission. Thirty‑eight (49%) patients (22 treated with antivirals) died within three months. The mean MELD and ∆MELD scores of the survival group were 19.5±4.4 and 0.2±3.7 respectively, and those of the mortality group were 23.5±5.5 and 7.9±6, respectively. The area under the receiver operating characteristic curve (AUC) for MELD, integrated MELD (iMELD), MELD with the addition of serum sodium (MELD-Na), updated MELD (upMELD), MELD excluding the international normalized ratio (INR; MELD-XI), United Kingdom MELD (UKMELD) and their ∆ scores were 0.72, 0.81, 0.77, 0.69, 0.65, 0.77 and 0.86, 0.83, 0.83, 0.82, 0.79 and 0.79, respectively. iMELD and MELD-Na significantly improved the accuracy of MELD (P<0.05). A cut-off value of 41.5 for the iMELD score can prognose 71% of mortalities with a specificity of 85%. In each pair of models, the ∆ score was superior to its counterpart, particularly when applied to patients with MELD ≤30. Decreased accuracy was observed for all models in the subset of patients treated with antivirals, although their baseline characteristics were comparable to those of untreated patients, while iMELD, MELD-Na and respective ∆ models remained superior with regard to the predictability. The iMELD and MELD-Na models predicted three-month mortality more accurately, while the ∆ models were superior to their counterparts when MELD ≤30; however, their performance was altered by antivirals, and thus requires optimization.
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Copy and paste a formatted citation
Spandidos Publications style
Xun Y, Shi J, Li C, Li D, Shi W, Pan Q, Guo J and Zang G: Prognostic performance of a series of model for end‑stage liver disease and respective Δ scores in patients with hepatitis B acute-on-chronic liver failure. Mol Med Rep 9: 1559-1568, 2014.
APA
Xun, Y., Shi, J., Li, C., Li, D., Shi, W., Pan, Q. ... Zang, G. (2014). Prognostic performance of a series of model for end‑stage liver disease and respective Δ scores in patients with hepatitis B acute-on-chronic liver failure. Molecular Medicine Reports, 9, 1559-1568. https://doi.org/10.3892/mmr.2014.1983
MLA
Xun, Y., Shi, J., Li, C., Li, D., Shi, W., Pan, Q., Guo, J., Zang, G."Prognostic performance of a series of model for end‑stage liver disease and respective Δ scores in patients with hepatitis B acute-on-chronic liver failure". Molecular Medicine Reports 9.5 (2014): 1559-1568.
Chicago
Xun, Y., Shi, J., Li, C., Li, D., Shi, W., Pan, Q., Guo, J., Zang, G."Prognostic performance of a series of model for end‑stage liver disease and respective Δ scores in patients with hepatitis B acute-on-chronic liver failure". Molecular Medicine Reports 9, no. 5 (2014): 1559-1568. https://doi.org/10.3892/mmr.2014.1983
Copy and paste a formatted citation
x
Spandidos Publications style
Xun Y, Shi J, Li C, Li D, Shi W, Pan Q, Guo J and Zang G: Prognostic performance of a series of model for end‑stage liver disease and respective Δ scores in patients with hepatitis B acute-on-chronic liver failure. Mol Med Rep 9: 1559-1568, 2014.
APA
Xun, Y., Shi, J., Li, C., Li, D., Shi, W., Pan, Q. ... Zang, G. (2014). Prognostic performance of a series of model for end‑stage liver disease and respective Δ scores in patients with hepatitis B acute-on-chronic liver failure. Molecular Medicine Reports, 9, 1559-1568. https://doi.org/10.3892/mmr.2014.1983
MLA
Xun, Y., Shi, J., Li, C., Li, D., Shi, W., Pan, Q., Guo, J., Zang, G."Prognostic performance of a series of model for end‑stage liver disease and respective Δ scores in patients with hepatitis B acute-on-chronic liver failure". Molecular Medicine Reports 9.5 (2014): 1559-1568.
Chicago
Xun, Y., Shi, J., Li, C., Li, D., Shi, W., Pan, Q., Guo, J., Zang, G."Prognostic performance of a series of model for end‑stage liver disease and respective Δ scores in patients with hepatitis B acute-on-chronic liver failure". Molecular Medicine Reports 9, no. 5 (2014): 1559-1568. https://doi.org/10.3892/mmr.2014.1983
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