From Child-Pugh to MELD score and beyond: Taking a walk down memory lane

Ruf, Andrés E.; Dirchwolf, Melisa; Freeman, Richard B.

doi:10.1016/j.aohep.2021.100535

Cited by 42 publications

(27 citation statements)

References 19 publications

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“…The MELD score was originally used to estimate survival of liver patients undergoing the transjugular intrahepatic portosystemic shunt (TIPS) [ 29 ]. The MELD score is currently used to determine patients' eligibility for liver transplantation [ 30 , 31 ]. In addition, the MELD score is used as a predictor of liver disease complications, such as GI bleeding and portal hypertension [ 27 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

Urinary BA Indices as Prognostic Biomarkers for Complications Associated with Liver Diseases

Alamoudi

Gautam

et al. 2022

International Journal of Hepatology

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Hepatobiliary diseases and their complications cause the accumulation of toxic bile acids (BA) in the liver, blood, and other tissues, which may exacerbate the underlying condition and lead to unfavorable prognosis. To develop and validate prognostic biomarkers for the prediction of complications of cholestatic liver disease based on urinary BA indices, liquid chromatography-tandem mass spectrometry was used to analyze urine samples from 257 patients with cholestatic liver diseases during a 7-year follow-up period. The urinary BA profile and non-BA parameters were monitored, and logistic regression models were used to predict the prognosis of hepatobiliary disease-related complications. Urinary BA indices were applied to quantify the composition, metabolism, hydrophilicity, and toxicity of the BA profile. We have developed and validated the bile-acid liver disease complication (BALDC) model based on BA indices using logistic regression model, to predict the prognosis of cholestatic liver disease complications including ascites. The mixed BA and non-BA model was the most accurate and provided higher area under the receiver operating characteristic (ROC) and smaller akaike information criterion (AIC) values compared to both non-BA and MELD (models for end stage liver disease) models. Therefore, the mixed BA and non-BA model could be used to predict the development of ascites in patients diagnosed with liver disease at early stages of intervention. This will help physicians to make a better decision when treating hepatobiliary disease-related ascites.

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Section: Introductionmentioning

confidence: 99%

Urinary BA Indices as Prognostic Biomarkers for Complications Associated with Liver Diseases

Alamoudi

Gautam

et al. 2022

International Journal of Hepatology

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“…The Child-Pugh score is an instrument to assess the degree of severity and prognosis of chronic liver disease (Ruf, et al, 2022). The scoring system uses five variables that have been empirically proven to visualize liver function regression: ascites, encephalopathy, serum bilirubin, albumin, and prothrombin time).…”

Section: Introductionmentioning

confidence: 99%

Ast to Platelet Ratio Index (Apri) and Degree of Severity Based on Child-Pugh Classification Among Cirrhosis Patients at Internal Medicine Ward in a Tertiary Hospital

Kurniawan

Widodo

Agustina

2022

MBIOM

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Highlights: 1. The Child-Pugh score is an instrument to assess the degree of severity and prognosis of chronic liver disease. 2. the rise in APRI score may predict the advance of cirrhosis stages. Abstract: Background: Simple diagnostic and screening methods are needed to assist with liver biopsy, which is not always available in local health facilities. Objective: To assess the AST-to-Platelet Count Index (APRI) as a means to predict the advance of cirrhosis stages as indicated in Child-Pugh classification. Material and Method: This research employed an observational descriptive study design to examine laboratory values such as serum AST and platelet count, which were then compared to Child-Pugh profiles among cirrhosis patients at an inpatient facility in a tertiary hospital of Dr Soetomo General Academic Hospital, Surabaya, Indonesia on 1 January – 31 December 2015. The sampling method for this research was total sampling from medical histories. Result: Data obtained were then analyzed and tabulated using the descriptive technique. As many as 191 samples were obtained, consisting of male (N=129, 67.54%) and female patients (N=62, 32.46%) with a ratio of 2.08:1. APRI score showed an increase in age, with a peak frequency of 68 patients (35.6%) in the range 50-59 years old. Male patients had a higher average APRI score (2.11) than their female counterparts (1.93). Patients from Child C were the majority in this research, consisting of 105 patients (54.9%), followed by Child B (N=65, 34.03%) and A (N=21, 10.9%). Conclusion: The proportion of patients with APRI score > 1.5 is increasing along with the degree of severity according to the Child-Pugh classification. This indicates that the rise in APRI score may predict the advance of cirrhosis stages.

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“…There are well‐established risk stratification models to predict clinical outcomes in patients with liver disease including the Child‐Turcotte‐Pugh (CTP) score, the model for end‐stage liver disease sodium (MELD‐Na) score, and the albumin‐bilirubin (ALBI) score. CTP is the oldest scoring system to assess prognosis in patients with cirrhosis 4 . However, the main limitation of utilizing this model is requiring two subjective variables to make an assessment, allowing scores to vary based on clinical judgment 4,5 .…”

Section: Introductionmentioning

confidence: 99%

“…CTP is the oldest scoring system to assess prognosis in patients with cirrhosis 4 . However, the main limitation of utilizing this model is requiring two subjective variables to make an assessment, allowing scores to vary based on clinical judgment 4,5 . The MELD‐Na score, initially used to predict the 90‐day mortality of patients with cirrhosis after a transjugular intrahepatic portosystemic shunt placement, 6,7 is an objective measure commonly used today for liver transplant prioritization, prediction of posttransplant mortality, and predict 30‐ and 90‐day morbidity and mortality after various surgical procedures 8,9 .…”

Section: Introductionmentioning

confidence: 99%

“…4 However, the main limitation of utilizing this model is requiring two subjective variables to make an assessment, allowing scores to vary based on clinical judgment. 4,5 The MELD-Na score, initially used to predict the 90-day mortality of patients with cirrhosis after a transjugular intrahepatic portosystemic shunt placement, 6,7 is an objective measure commonly used today for liver transplant prioritization, prediction of posttransplant mortality, and predict 30and 90-day morbidity and mortality after various surgical procedures. 8,9 Although the MELD-Na score is the system of choice when allocating for a liver transplantation, it is argued to be a poor predictor of posthepatectomy morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

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Albumin‐bilirubin score is superior to platelet‐albumin‐bilirubin score and model for end‐state liver disease sodium for predicting posthepatectomy liver failure

Wong

Holguin

Tarren

et al. 2022

Journal of Surgical Oncology

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Background Risk stratification for patients undergoing hepatectomy can be attempted using established models. This study compares the platelet‐albumin‐bilirubin (PALBI) score with albumin‐bilirubin (ALBI) and model for end‐stage liver disease sodium (MELD‐Na) for predicting posthepatectomy liver failure (PHLF) and 30‐day mortality. Methods The 2014–2018 NSQIP database was queried for patients who underwent elective hepatectomy. Multivariable logistic regressions assessed associations of posthepatectomy outcomes with patient and clinical characteristics. Predictive accuracy of the grading systems was evaluated using receiver operator characteristic (ROC) curves and calculating area under the curve (AUC). Results Severe PHLF (Grade B/C) and mortality were present in 2.58% (N = 369) and 1.2% (N = 171) of patients who underwent hepatectomy (N = 13 925), respectively. ALBI Grade 2/3 had a stronger association with severe PHLF (odds ratio [OR] = 1.62, p < 0.01) and mortality (OR = 2.06, p < 0.005) than PALBI Grade 2/3 (OR = 1.14, p = 0.43 for PHLF and OR = 2.01, p < 0.005 for mortality) or MELD‐Na ≥10 (OR = 1.29, p = 0.25 for PHLF and OR = 1.84, p < 0.03). ALBI had a higher AUC (0.671) than PALBI (0.625) and MELD‐Na (0.627) for predicting severe PHLF. ALBI had a higher AUC (0.695) than PALBI (0.642) for predicting 30‐day mortality. Conclusions ALBI was a more accurate predictor of severe PHLF and 30‐day mortality than MELD‐Na and PALBI for patients who underwent hepatectomy.

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From Child-Pugh to MELD score and beyond: Taking a walk down memory lane

Cited by 42 publications

References 19 publications

Urinary BA Indices as Prognostic Biomarkers for Complications Associated with Liver Diseases

Urinary BA Indices as Prognostic Biomarkers for Complications Associated with Liver Diseases

Ast to Platelet Ratio Index (Apri) and Degree of Severity Based on Child-Pugh Classification Among Cirrhosis Patients at Internal Medicine Ward in a Tertiary Hospital

Albumin‐bilirubin score is superior to platelet‐albumin‐bilirubin score and model for end‐state liver disease sodium for predicting posthepatectomy liver failure

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