Model for end-stage liver disease-3.0 vs. model for end-stage liver disease-sodium: mortality prediction in Korea
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Background/Aims: The model for end-stage liver disease (MELD) serves as an indicator for short-term mortality among patients diagnosed with liver cirrhosis (LC) and is used to prioritize patients for liver transplantation. In 2021, the updated version of MELD, MELD-3.0, was introduced to improve the accuracy of the mortality prediction of MELD. Therefore, this study aimed to compare the efficacy of MELD 3.0 and MELD-Na in predicting mortality among Korean patients with LC. Methods: A retrospective review was conducted using the medical records of patients diagnosed with LC who were admitted to Konkuk University Hospital From 2011 to 2021. The study calculated the predictive values of MELD-Na and MELD-3.0 for 3- and 6-months mortality using the area under the receiver operating curve (AUROC) and compared the results using the DeLong test. Results: Of the 3,034 patients enrolled in the study, 339 (11.2%) died within 3 months and 421 (14.4%) died within 6 months. The AUROCs values for predicting 3 months mortality were 0.846 for MELD-Na and 0.851 for MELD-3.0. The corresponding AUROC values for predicting 6 months mortality were 0.843 for MELD-Na and 0.848 for MELD-3.0. MELD-3.0 exhibited better discrimination ability than MELD-Na for both 3 (p = 0.03) and 6 months mortality (p = 0.01). Conclusions: Our study found a significant difference between the performance of MELD-3.0 and MELD-Na in Korean patients with LC.
Abstract
Background/Aims: The model for end-stage liver disease (MELD) serves as an indicator for short-term mortality among patients diagnosed with liver cirrhosis (LC) and is used to prioritize patients for liver transplantation. In 2021, the updated version of MELD, MELD-3.0, was introduced to improve the accuracy of the mortality prediction of MELD. Therefore, this study aimed to compare the efficacy of MELD 3.0 and MELD-Na in predicting mortality among Korean patients with LC. Methods: A retrospective review was conducted using the medical records of patients diagnosed with LC who were admitted to Konkuk University Hospital From 2011 to 2021. The study calculated the predictive values of MELD-Na and MELD-3.0 for 3- and 6-months mortality using the area under the receiver operating curve (AUROC) and compared the results using the DeLong test. Results: Of the 3,034 patients enrolled in the study, 339 (11.2%) died within 3 months and 421 (14.4%) died within 6 months. The AUROCs values for predicting 3 months mortality were 0.846 for MELD-Na and 0.851 for MELD-3.0. The corresponding AUROC values for predicting 6 months mortality were 0.843 for MELD-Na and 0.848 for MELD-3.0. MELD-3.0 exhibited better discrimination ability than MELD-Na for both 3 (p = 0.03) and 6 months mortality (p = 0.01). Conclusions: Our study found a significant difference between the performance of MELD-3.0 and MELD-Na in Korean patients with LC.
참고문헌 (13)
- Kamath PS, "A model to predict survival in patients with end-stage liver disease", Hepatology, 33, pp.464~470 (2001)
- Wiesner R, "Model for end-stage liver disease (MELD) and allocation of donor livers", Gastroenterology, 124, pp.91~96 (2003)
- Leise MD, "A revised model for end-stage liver disease optimizes prediction of mortality among patients awaiting liver transplantation", Gastroenterology, 140, pp.1952~1960 (2011)
- Kim WR, "Hyponatremia and mortality among patients on the liver-transplant waiting list", N Engl J Med, 359, pp.1018~1026 (2008)
- Luca A, "An integrated MELD model including serum sodium and age improves the prediction of early mortality in patients with cirrhosis", Liver Transpl, 13, pp.1174~1180 (2007)
- Ruf AE, "Addition of serum sodium into the MELD score predicts waiting list mortality better than MELD alone", Liver Transpl, 11, pp.336~343 (2005)
- Guy J, "New model for end stage liver disease improves prognostic capability after transjugular intrahepatic portosystemic shunt", Clin Gastroenterol Hepatol, 7, pp.1236~1240 (2009)
- Yoon JH, "Changing trends in liver cirrhosis etiology and severity in Korea : the increasing impact of alcohol", J Korean Med Sci, 36, pp.e145~ (2021)
- Locke JE, "Quantifying sex-based disparities in liver allocation", JAMA Surg, 155, pp.e201129~ (2020)
- Kim WR, "MELD 3. 0 : the model for end-stage liver disease updated for the modern era", Gastroenterology, 161, pp.1887~1895 (2021)
- Asrani SK, "A model for glomerular filtration rate assessment in liver disease(GRAIL)in the presence of renal dysfunction", Hepatology, 69, pp.1219~1230 (2019)
- Musso G, "Association of non-alcoholic fatty liver disease with chronic kidney disease : a systematic review and meta-analysis", PLoS Med, 11, pp.e1001680~ (2014)
- Lai JC, "Height contributes to the gender difference in wait-list mortality under the MELD-based liver allocation system", Am J Transplant, 10, pp.2658~2664 (2010)
