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Title: MELD score and serum sodium in the prediction of survival of patients with cirrhosis awaiting liver transplantation
Author: Londoño, María Carlota
Cárdenas Vásquez, Andrés
Guevara, Mónica
Quintó, Llorenç
Heras, Dara de las
Navasa, Miquel
Rimola Castellá, Antonio
García-Valdecasas Salgado, Juan Carlos
Arroyo, Vicente
Ginès i Gibert, Pere
Keywords: Cirrosi hepàtica
Trasplantament hepàtic
Sodi en l'organisme
Pronòstic mèdic
Hepatic cirrhosis
Hepatic transplantation
Sodium in the body
Issue Date: 2007
Publisher: BMJ Group
Abstract: Background/Aims: Serum sodium predicts prognosis in cirrhosis and may improve the prognostic accuracy of the model for end-stage liver disease (MELD) score, but the available information is limited. The aim of the present study was to assess the prognostic value of serum sodium in the prediction of survival at 3 and 12 months after listing in patients with cirrhosis awaiting liver transplantation, and to compare its predictive value with that of the MELD score. Patients and methods: 308 consecutive patients with cirrhosis listed for transplantation during a 5-year period were included in the study. The end-point was survival at 3 and 12 months before transplantation. Variables obtained at the time of listing were analysed for prognostic value using multivariable analysis. Accuracy of prognostic variables was analysed by receiver operating characteristic (ROC) curves. Results: The MELD score and serum sodium concentration were the only independent predictors of survival at 3 and 12 months after listing. Low serum sodium was associated with an increased risk of death in all subpopulations of patients with cirrhosis categorised according to the major complication developed before listing. The area under the ROC curves for serum sodium and MELD score was not significantly different both at 3 months (0.83 vs 0.79, respectively) and at 12 months (0.70 vs 0.77, respectively). The addition of serum sodium did not significantly improve the accuracy of the MELD score in the prediction of survival at 3 and 12 months. Conclusion: In patients with cirrhosis awaiting liver transplantation, serum sodium and MELD were found to be independent predictors of survival. Larger studies are needed to determine whether the addition of serum sodium to MELD can improve its prognostic accuracy.
Note: Reproducció digital del document publicat a:
It is part of: Gut, 2007, vol. 56, núm. 9, p. 1283-1290
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ISSN: 0017-5749
Appears in Collections:Articles publicats en revistes (Medicina)

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