Values of MELD,MELD-Na and SOFA Scores for Prediction of Liver Failure

Objective:To investigate the value of model for end-stage liver disease(MELD) score,MELD with incorporation of serum sodium(MELD-Na) score and the sequential organ failure assessment(SOFA) score for evaluation of prognosis of liver failure.Methods:A total of 290 consecutive patients with liver failure were included in the study and divided into two groups(death group and survival group) according to the prognosis.The levels of total bilirubin(TBIL),serum creatinine(Cr),prothrombin time(PT),PT international normalized ratio(INR),platelet count(PLT),MELD,MELD-Na and SOFA were calculated respectively and the comparative analysis was performed.Areas under the receiver operating characteristic curve(AUC-ROC) of MELD,MELD-Na and SOFA were used to assess the prognosis in patients with liver failure.Results:The values of age,TBIL,Cr,INR,MELD,MELD-Na and SOFA were significantly higher in death group than those in survival group(P 0.01).The serum level of Na+ was significantly lower in death group than that of survival group(P 0.01).The mortality of liver failure was higher in patients with the increased scores of MELD,MELD-Na and SOFA.The area under curve(AUC) values generated by the ROC curves was higher for SOFA score(AUC=0.805) than that of MELD-Na score(AUC=0.732) and MELD score(AUC=0.714) respectively.The cut-off scores of three systems were 7.50(SOFA),28.14(MELD-Nn) and 25.01(MELD) respectively,which could discriminate higher and lower mortality accurately.Conclusion:MELD,MELD-Na and SOFA scores have appreciable value to evaluate the prognosis in patients with liver failure.SOFA is more accurate than that of MELD and MELD-Na scores in assessing prognosis of liver failure.