Objective: To identify the prognostic score that is the best predictor of outcome in patients hospitalized with decompensated liver cirrhosis. Material and Methods: In thisprospective study, 126 patients were enrolled and followed up for 29 months. For each patient, prognostic scores were calculated; these included the Child-Turcotte-Pugh score (CTP score), CTP creatinine-modified I score, CTP creatinine-modified II score, Model for End-Stage Liver Disease (MELD score), MELD model for end-stage liver disease sodium-modified score, Integrated MELD score, updated MELD score, United Kingdom MELD, and the MELD score remodeled by serum sodium index (MESO index). Cox regression analysis was used to assess the ability of each of the scores for predicting mortality in patients with alcoholic cirrhosis. Their discriminatory ability was evaluated using receiver operating characteristic (ROC) curve analysis. Results: The updated MELD score had the highest predictive value (3.29) among the tested scores (95% CI: 2.26-4.78). ROC curve analysis demonstrated that the MELD score of 22.50 (AUC = 0.914, 95% CI: 0.849-0.978; p < 0.001) had the best discriminative ability for identifying patients with a high risk of mortality; the next best was the MESO index of 16.00 (AUC = 0.912, 95% CI: 0.847-0.978; p < 0.001). Conclusion: The risk of mortality was highest in patients with the highest updated MELD score, and those with MELD scores >22.50 and a MESO index >16.00.

Survival of patients with bleeding from esophageal varices in the short-term follow up can be predicted by following CTP score and creatinine modified CTP scores. Patients with bleeding from esophageal varices who have CTP score and CTP-crea I score higher than 10.5 and CTP-crea II score higher than 11.5, have statistically significantly higher risk from mortality within one-month follow-up compared to patients with bleeding from esophageal varices who have lower numerical values of scores of the CTP group.

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Background: Liver cirrhosis is the final stage of chronic liver disease. We aimed to evaluate non-invasive scores as predictors of complications and outcome in cirrhotic patients. Methods: A total of 150 cirrhotic patients were included. Models for end-stage liver disease (MELD), albumin-bilirubin (ALBI) score, neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MoLR), and neutrophil-lymphocyte-albumin ratio (NLA) scores were tested in relation to the development of complications and mortality using receiver operating characteristic (ROC) curves. Results: The ROC curve analysis showed (area under the curve) AUC values of NLR, NLA, ALBI, and MELD of 0.711, 0.730, 0.627, and 0.684, respectively, for short-term mortality. MELD, ALBI, and NLA scores showed a statistically significant correlation with hepatic encephalopathy (p = 0.000 vs. 0.014 vs. 0.040, respectively), and the MELD cut-off value of 16 had a sensitivity of 70% and a specificity of 52% (AUC: 0.671, 95% CI (0.577–0.765)). For the assessment of the presence of ascites, the AUC values for NLA and MoLR were 0.583 and 0.658, respectively, with cut-offs of 11.38 and 0.44. Conclusions: MELD, ALBI, and NLA are reliable predictors of hepatic encephalopathy. NLA and MoLR showed a significant correlation with the presence of ascites, and MELD, ALBI, NLR, and NLA have prognostic value to predict 30-day mortality in cirrhotic patients.

Introduction. Bacterial infections are common complications and the cause of death in patients with cirrhosis and ascites. There is no standard method for a rapid and low-cost diagnosis, and its prognosis is poor. Objective. The aim of this study was to determine the etiology and frequency of bacterial infections in patients with liver cirrhosis of different etiology, and the influence of bacterial infections on the prognosis in patients with liver cirrhosis and ascites. Methods. Sixty-four patients with cirrhosis and ascites were included in the study. The diagnosis of spontaneous bacterial peritonitis was established based on the diagnostic abdominal paracentesis and the results of biochemical, cytological and microbiologic analysis of ascitic fluid. The diagnosis of urinary infection and pneumonia were made according to the standard criteria. Results. Spontaneous bacterial peritonitis was diagnosed in 23 (35.9%) patients, urinary infections in 16 (25%) and pneumonia in 11 (17.2%). Gram positive and gram negative bacteria in spontaneous bacterial peritonitis were etiologically almost equally represented (52%; 48%). The most frequent causes were Escherichia coli and Staphylococcus aureus. In 81% of patients urinary infections were caused by gram negative bacteria (Escherichia coli in 44%). The most frequent cause of pneumonia was Streptococcus pneumoniae (46%). Conclusion. Spontaneous bacterial peritonitis, urinary infections and bronchopneumonia are the most frequent bacterial infections in patients with liver cirrhosis and ascites. A timely recognition of bacterial infections and the initiation of treatment have a positive effect on the prognosis of such patients.