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. 2008 Jan 14;14(2):286-91.
doi: 10.3748/wjg.14.286.

Child-Pugh-Turcott versus Meld score for predicting survival in a retrospective cohort of black African cirrhotic patients

K A Attia  1 , K C Ackoundou-N'guessan, A T N'dri-Yoman, A K Mahassadi, E Messou, Y F Bathaix, Y H Kissi
Affiliations

Child-Pugh-Turcott versus Meld score for predicting survival in a retrospective cohort of black African cirrhotic patients

K A Attia et al. World J Gastroenterol. .

Abstract

Aim: To compare the performance of the Child-Pugh-Turcott (CPT) score to that of the model for end-stage liver disease (MELD) score in predicting survival of a retrospective cohort of 172 Black African patients with cirrhosis on a short and mid-term basis.

Methods: Univariate and multivariate (Cox model) analyses were used to identify factors related to mortality. Relationship between the two scores was appreciated by calculating the correlation coefficient. The Kaplan Meier method and the log rank test were used to elaborate and compare survival respectively. The Areas Under the Curves were used to compare the performance between scores at 3, 6 and 12 mo.

Results: The study population comprised 172 patients, of which 68.9% were male. The mean age of the patient was 47.5 +/- 13 years. Hepatitis B virus infection was the cause of cirrhosis in 70% of the cases. The overall mortality was 31.4% over 11 years of follow up. Independent factors significantly associated with mortality were: CPT score (HR = 3.3, 95% CI [1.7-6.2]) (P < 0.001) (stage C vs stage A-B); Serum creatine (HR = 2.5, 95% CI [1.4-4.3]) (P = 0.001) (Serum creatine > 1.5 mg/dL versus serum creatine < 1.5 mg/dL); MELD score (HR = 2.9, 95% CI [1.63-5.21]) (P < 0.001) (MELD > 21 vs MELD < 21). The area under the curves (AUC) that predict survival was 0.72 and 0.75 at 3 mo (P = 0.68), 0.64 and 0.62 at 6 mo (P = 0.67), 0.69 and 0.64 at 12 mo (P = 0.38) respectively for the CPT score and the MELD score.

Conclusion: The CPT score displays the same prognostic significance as does the MELD score in black African patients with cirrhosis. Moreover, its handling appears less cumbersome in clinical practice as compared to the latter.

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Figures

Figure 1
Figure 1
Survival according to the CPT score.
Figure 2
Figure 2
Survival according to the MELD score. 1Through value of the MELD score significantly associated with mortality.
Figure 3
Figure 3
Comparison between AUROC of the CPT score and of the MELD score in predicting survival at 3 mo. CPT: Child-Pugh-Turcott; MELD: Model for End-stage liver disease; Ref. Line: Reference line.
See this image and copyright information in PMC

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