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Comparative Study
. 2016 Feb;70(1):48-52.
doi: 10.5455/medarh.2016.70.48-52. Epub 2016 Jan 31.

Prognostic Significance of Ascites and Serum Sodium in Patients with Low Meld Scores

Dzanela Prohic  1 , Rusmir Mesihovic  1 , Nenad Vanis  1 , Amra Puhalovic  1
Affiliations
Comparative Study

Prognostic Significance of Ascites and Serum Sodium in Patients with Low Meld Scores

Dzanela Prohic et al. Med Arch. 2016 Feb.

Abstract

Objective: to determine ascites and serum sodium significance in short term mortality prediction in patients with advanced liver cirrhosis.

Methods: a cohort of 115 cirrhotic patients referred to our Department were followed up for 6 months in non-transplant settings. The c index equivalent to the area under the receiver operating curve (ROC) was calculated and compared to estimate the short-term prognostic accuracy of the following parameters: ascites, serum sodium and MELD score.

Results: in patients with a MELD score less than 21, ascites and low serum sodium (c index 0,687, p<0 0,001 and 0,748, p<0,001 respectively) showed better prognostic accuracy and were independent predictors of mortality. For MELD scores above 21, only MELD was an independent mortality prognostic factor (c index 0,710, p<0,001).

Conclusion: in our study, sample ascites and low serum sodium help identify patients with advanced liver disease who are at high risk of mortality despite low MELD scores. These parameters should be considered as additional prognostic parameters that could improve available treatment options and outcomes in this group of patients.

Keywords: ascites; cirrhosis; mortality; serum sodium MELD.

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Conflict of interest statement

• Conflict of interest: none declared.

Figures

Figure 1
Figure 1
Reciver operating curve (ROC) for parameters MELD and ascites, as predictors of 6 months mortality
Figure 2
Figure 2
Reciver operating curve (ROC) for parameter S-Na as predictor of 6 months mortality
Figure 3
Figure 3
Cross tabulation figure of different subcategories of S-Na, MELD and ascites according to different MELD groups, MELD <21 and MELD>21
See this image and copyright information in PMC

References

    1. Runyon BA. AASLD. Introduction to the revised American Association for the Study of Liver Diseases Practice Guideline management of adult patients with ascites due to cirrhosis 2012. Hepatology. 2013;57:1651. - PubMed
    1. Asrani SK, Kamath PS. Natural history of cirrhosis. Curr Gastroenterol Rep. 2013 Feb;15(2):308. - PubMed
    1. Planas R, Montoliu S, Balleste B, Rivera M, Miquel M, Masnou H, et al. Natural history of patients hospitalized for management of cirrhotic ascites. Clin Gastroenterol Hepatol. 2006;4:1385–94. - PubMed
    1. Ginès P, Cárdenas A. The management of ascites and hyponatremia in cirrhosis. Semin Liver Dis. 2008;28(1):43–58. - PubMed
    1. Yu C, Sharma N, Saab S. Hyponatremia: clinical associations, prognosis, and treatment in cirrhosis. Exp Clin Transplant. 2013 Feb;11(1):3–11. - PubMed

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