ENHANCEMENT OF CIRRHOSIS MORTALITY PREDICTION BY INCLUDING HEPATIC ENCEPHALOPATHY TO MELD3.0 IN A NATIONAL VETERAN COHORT.

Abstract

Despite negative outcomes, hepatic encephalopathy (HE) is not included in model-for-end-stage liver disease (MELD) scores, including MELD3.0. In a national Veterans affairs (VA) database, we studied the additive mortality predictive impact of a documented inpatient overt HE diagnosis on MELD3.0 and MELD-Na scores in 75,327 Veterans (26.8% with HE, 22% 90-day and 37% 1-year mortality). The addition of HE to MELD3.0 and MELD-Na significantly improved their mortality prediction with interactions at 90-days and 1-year on multivariable regression. A documented inpatient HE episode is additive to the mortality prediction of MELD3.0 by 4-5 extra points and could enhance future MELD iterations.