Three models for end-stage liver disease prognosis in patients with chronic severe hepatitis B

Objective To investigate the prognostic value of three models for the end-stage liver disease(MELD) of chronic severe hepatitis B.Methods A total of 193 adult patients with chronic severe hepatitis B were reviewed retrospectively.The scores of MELD,MELD with the incorporation of serum sodium(MELD-Na) and MELD to sodium index(MESO) for patients were calculated.The 3-month mortality of patients was measured,and the validity of the models was determined by the means of concordance(c)-statistics.Results One hundred and forty two patients(73.6%)were died within 3 months.The median(95% confidence interval) scores of MELD,MELD-Na and MESO at hospital admission were 30(15-61),35.0(19.0-84.9) and 2.3(1.2-5.2)among patients died within 3 months,and were 23(16-34),24.0(16.0-49.9)and 1.6(1.2-2.5)among the survival patients,respectively.The scores of MELD,MELD-Na and MESO were significantly different between the survival and death groups(P0.01).Areas under curve(AUC) were the highest for MESO(0.850),followed by MELD-Na(0.833) and MELD(0.830).Conclusions All three models can be used for the prognosis of chronic severe hepatitis B patients.The method of MESO has a better prognostic value as compared to MELD-Na and MESO.The survival chance of patients is negatively associated with the calculated scores of models.