Model for end-stage liver disease-3.0 vs. model for end-stage liver disease-sodium: mortality prediction in Korea.

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL Korean Journal of Internal Medicine Pub Date : 2024-03-01 Epub Date: 2024-02-01 DOI:10.3904/kjim.2023.005

Jeong Han Kim, Yong Joon Cho, Won Hyeok Choe, So Young Kwon, Byung-Chul Yoo

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Abstract

Background/aims: The model for end-stage liver disease (MELD) serves as an indicator for short-term mortality among patients diagnosed with liver cirrhosis (LC) and is used to prioritize patients for liver transplantation. In 2021, the updated version of MELD, MELD-3.0, was introduced to improve the accuracy of the mortality prediction of MELD. Therefore, this study aimed to compare the efficacy of MELD 3.0 and MELD-Na in predicting mortality among Korean patients with LC.

Methods: A retrospective review was conducted using the medical records of patients diagnosed with LC who were admitted to Konkuk University Hospital From 2011 to 2021. The study calculated the predictive values of MELD-Na and MELD-3.0 for 3- and 6-months mortality using the area under the receiver operating curve (AUROC) and compared the results using the DeLong test.

Results: Of the 3,034 patients enrolled in the study, 339 (11.2%) died within 3 months and 421 (14.4%) died within 6 months. The AUROCs values for predicting 3 months mortality were 0.846 for MELD-Na and 0.851 for MELD-3.0. The corresponding AUROC values for predicting 6 months mortality were 0.843 for MELD-Na and 0.848 for MELD-3.0. MELD-3.0 exhibited better discrimination ability than MELD-Na for both 3 (p = 0.03) and 6 months mortality (p = 0.01).

Conclusion: Our study found a significant difference between the performance of MELD-3.0 and MELD-Na in Korean patients with LC.

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终末期肝病-3.0 模型与终末期肝病-钠模型：韩国的死亡率预测。

背景/目的：终末期肝病模型（MELD）是诊断为肝硬化（LC）的患者短期死亡率的指标，用于确定肝移植患者的优先顺序。2021 年，MELD 的更新版本 MELD-3.0 问世，提高了 MELD 预测死亡率的准确性。因此，本研究旨在比较 MELD 3.0 和 MELD-Na 在预测韩国 LC 患者死亡率方面的效果：方法：使用建国大学医院 2011 年至 2021 年收治的确诊为 LC 患者的病历进行回顾性研究。研究使用接收者操作曲线下面积（AUROC）计算了 MELD-Na 和 MELD-3.0 对 3 个月和 6 个月死亡率的预测值，并使用 DeLong 检验对结果进行了比较：在 3034 名参与研究的患者中，339 人（11.2%）在 3 个月内死亡，421 人（14.4%）在 6 个月内死亡。MELD-Na 预测 3 个月死亡率的 AUROCs 值为 0.846，MELD-3.0 预测 3 个月死亡率的 AUROCs 值为 0.851。预测 6 个月死亡率的相应 AUROC 值为：MELD-Na 为 0.843，MELD-3.0 为 0.848。在 3 个月死亡率（p = 0.03）和 6 个月死亡率（p = 0.01）方面，MELD-3.0 都比 MELD-Na 表现出更好的分辨能力：我们的研究发现，在韩国 LC 患者中，MELD-3.0 和 MELD-Na 的表现存在明显差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Korean Journal of Internal Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

5.10

自引率

4.20%

发文量

129

审稿时长

20 weeks

期刊介绍： The Korean Journal of Internal Medicine is an international medical journal published in English by the Korean Association of Internal Medicine. The Journal publishes peer-reviewed original articles, reviews, and editorials on all aspects of medicine, including clinical investigations and basic research. Both human and experimental animal studies are welcome, as are new findings on the epidemiology, pathogenesis, diagnosis, and treatment of diseases. Case reports will be published only in exceptional circumstances, when they illustrate a rare occurrence of clinical importance. Letters to the editor are encouraged for specific comments on published articles and general viewpoints.