Prognosis analysis on patients with chronic severe hepatitis using the criterion of model for end_stage liver disease

Objective To study the clinical practical use of the model for end_stage liver disease (MELD) and assess its validity in predicting the prognosis of the chronic severe hepatitis patients. The optimal cut_off values of MELD to discriminate between deceased and surviving patients is calculated by using ROC curve.Methods The clinical data of 391 patients with chronic severe hepatitis among 2003～2005 in our hospital were analyzed, and they were graded with MELD formula. The death rate was observed within three months. Results Two humdred and thirty six patients died within 3_month and the mortality was 60.6%.The mortality of the patients whose MELD score were less than 30, 30～40 and higher than 40 were 38.1%(86/226), 87.6% (106/121) and 100% (44/44) respectively. The optimal cut_off value of MELD score to predict the prognosis of patients was 28 whose sensitivity and specificity were 69.2% and 86.4% respectively, and c_statistic was 0.837(95% CI 0.798～0.875). MELD scores had positive relation to serum bilirubin, serum creatinine, prothrombrin time, and they had negative relation to the prognosis of the patients.Conclusion The MELD score can act as a disease's severity index for patients with chronic severe hepatitis,and the mortality of the patient increases with the higher MELD score.The MELD can accurately predict the short_term prognisis of patients with chronic severe hepatitis.