Model for end-stage liver disease score versus Child score in predicting the outcome of surgical procedures in patients with cirrhosis

作     者：Maarouf A Hoteit Amaar H Ghazale Andrew J Bain Eli S Rosenberg Kirk A Easley Frank A Anania Robin E Rutherford 

作者机构：Division of Digestive DiseasesEmory UniversityAtlanta GeorgiaUnited States Department of Internal MedicineEmory UniversityAtlantaGeorgiaUnited States Department of Biostatistics-Rollins School of Public HealthEmory UniversityAtlanta GeorgiaUnited States 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2008年第14卷第11期

页      面：1774-1780页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：肝硬化 预后 手术治疗 外科规程 并发症 

摘      要：AIM:To determine factors affecting the outcome of patients with cirrhosis undergoing surgery and to compare the capacities of the Child-Turcotte-Pugh(CTP) and model for end-stage liver disease(MELD)score to predict that outcome. METHODS:We reviewed the charts of 195 patients with cirrhosis who underwent surgery at two teaching hospitals over a five-year *** combined endpoint of death or hepatic decompensation was considered to be the primary endpoint. RESULTS:Patients who reached the endpoint had a higher MELD score,a higher CTP score and were more likely to have undergone an urgent *** patients undergoing elective surgical procedures,no statistically significant difference was noted in the mean MELD(12.8±3.9 vs 12.6±4.7,P=0.9)or in the mean CTP(7.6±1.2 vs 7.7±1.7,P=0.8)between patients who reached the endpoint and those who did *** mean scores were higher in the patients reaching the endpoint in the case of urgent procedures(MELD:22.4± 8.7 vs 15.2±6.4,P=0.0007;CTP:9.9±1.8 vs 8.5±1.8, P=0.008).The performances of the MELD and CTP scores in predicting the outcome of urgent surgery were only fair,without a significant difference between them (AUC=0.755±0.066 for MELD vs AUC=0.696±0.070 for CTP,P=0.3). CONCLUSION:The CTP and MELD scores performedequally,but only fairly in predicting the outcome of urgent surgical *** studies are needed to better define the factors capable of predicting the outcome of elective surgical procedures in patients with cirrhosis.