MELD scoring system in evaluating the curative effect of MARS and prognosis of the patients with chronic severe hepatitis

Objective We analyze the curative effect of MARS treatment in chronic severe hepatitis B patients and the prediction accuracy of the short term prognosis using the MELD score. Methods Sixty chronic severe hepatitis B patients are analyzed using MELD score in our study, and the risk of death within 3-month were compared. ROC curve was used to analyze the prediction accuracy. Results Patients were divided into three categories according to the MELD score: MELD≤30, 30MELD40 and MELD≥40. Patients having a MELD≤30, 30MELD40 and MELD≥ 40 experienced a mortality 20.0%, 34.3% and 94.4%, respectively, the 3-month mortality rises as the MELD score increases, there is significant difference in mortality among the three groups (P0.05). There are significant differences in examinations before and after MARS treatment between the MELD ≤30 and 30MELD 40 group (P0.05). Fifty percent of the patients whose MELD is less than 40 survived longer than 3 months. Half of the patients whose MELD were 40 and over than 40 survived only for 1.54 months. MELD score is able to accurately predict the 3-month survival of the patients, the C-statistic for the MELD score’s prediction of 3-month survival is 0.789, the best cutoff value is 32, sensitivity is 80.1%, specificity is 50.1%. Conclusions MELD score is able to accurately predict the short term prognosis of the patients with chronic severe hepatitis. MELD score is an index of severity of chronic severe hepatitis and markers of advanced stages. MARS treatment is able to improve the short term survival of some chronic severe hepatitis patients.