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Korean J Gastroenterol  <  Volume 50(2); 2007 <  Articles

Korean J Gastroenterol 2007; 50(2): 92-100  
간경변 환자에서 CTP, MELD, MELD-Na 점수의 단기 사망률 예측에 대한 비교 분석
김세윤 ( Se Yune Kim ) , 임형준 ( Hyung Joon Yim ) , 이준영 ( June Young Lee ) , 이범재 ( Beom Jae Lee ) , 김동일 ( Dong Il Kim ) , 정성우 ( Sung Woo Jung ) , 한우식 ( Woo Sik Han ) , 이종섭 ( Jong Sup Lee ) , 구자설 ( Ja Seol Koo ) , 서연석 ( Yeon Seok Seo ) , 연종은 ( Jong Eun Yeon ) ,
Published online: August 25, 2007.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: MELD-Na (model for end-stage liver disease with incorporation of serum sodium) was suggested to provide better survival prediction than MELD alone for patients with end stage liver disease. However, there is no data verifying the usefulness of MELD-Na for predicting short term mortality of cirrhotic patients in Korea. This study was aimed to determine whether MELD-Na would be more accurate in predicting short term mortality than other scoring systems such as Child-Turcotte-Pugh (CTP) or MELD. Methods: Data from 355 patients admitted due to liver cirrhosis were retrospectively reviewed. The cumulative survival rates were obtained. Prediction of mortality rate for three months and one year were analyzed using the area under the receiver`s operating characteristics curve (AUC). Results: One hundred patients (28%) died during the study period. All of the three systems showed significant differences in the cumulative survival rate according to the scores on admission (p<0.001). The AUC of CTP, MELD, and MELD-Na in predicting three-months mortality were 0.828, 0.845, and 0.862 (p>0.05), and the AUC of each score system for death within one year were 0.792, 0.800, and 0.831, respectively (p>0.05). The AUC of MELD-Na in predicting short term death were the highest, although it was not statistically significant. Multivariate analysis showed that only MELD-Na was significantly related to three-month mortality (p=0.012). Conclusions: MELD-Na is more appropriate in predicting short term mortality, but larger scale studies are needed to confirm the superiority of MELD-Na to MELD and CTP in patients with liver cirrhosis. (Korean J Gastroenterol 2007;50:92-100)
Keywords: 사망률, CTP, MELD, MELD-Na, Mortality


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