Prognostic Models for Survival in Patients with Stable Cirrhosis: A Multicenter Cohort Study.
Dig Dis Sci
; 62(5): 1363-1372, 2017 May.
Article
en En
| MEDLINE
| ID: mdl-28251503
ABSTRACT
BACKGROUND:
Two models are mostly used to predict survival in cirrhosis the Child-Pugh score (CP score) and the model for end-stage liver disease score (MELD score).AIMS:
The aim of this study is to evaluate the CP score and the MELD score for short- and long-term prognosis in cirrhosis, as well as CP-creatinine score, MELD-Na score, and UKELD score.METHODS:
One thousand and forty-seven patients from five referral centers were included men/women 620/427, median age 58 years (IQR 48-66), median follow-up 33 months (IQR 12-74), CP (A/B/C) 493/357/147, CP score 7 (IQR 5-9), MELD score 12 (IQR 9-16). The performance of each score was evaluated by the Cox hazard model in terms of their discrimination ability (C-index and Somer's D) and calibration (3, 12 months). Internal validation was done with bootstrapping (100 samples).RESULTS:
Three hundred and fifty-two patients (33.6%) died. All scores were significantly associated with overall mortality, when assessed by univariate Cox analysis. CP-creatinine score performed significantly better than all other scores [bootstrap C-index 0.672, 95% CI 0.642-0.703, bootstrap Somer's D 0.344 (0.285-0.401)], apart from CP score, which showed similar performance. Inclusion in the multivariable Cox model of age together with CP-creatinine score improved the discriminative ability of the model [bootstrap C-index (95% CI) 0.700 (0.661-0.740)]. In terms of calibration, CP-creatinine score was the best for both 3- and 12-month survival in the total population.CONCLUSIONS:
CP score and CP-creatinine score have better prognostic value compared to MELD score, MELD-Na score, and UKELD score for predicting short- and long-term mortality in patients with stable cirrhosis.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Cirrosis Hepática
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Dig Dis Sci
Año:
2017
Tipo del documento:
Article
País de afiliación:
Grecia