Change in model for end-stage liver disease score at two weeks,as an indicator of mortality or liver transplantation at 60 days in acute-on-chronic liver failure

作     者：Rajneesh Kumar Thinesh Lee Krishnamoorthy Hiang Keat Tan Hock Foong Lui Wan Cheng Chow 

作者机构：Department of Gastroenterology and HepatologySingapore General HospitalSingapore 

出 版 物：《Gastroenterology Report》 (胃肠病学报道（英文）)

年 卷 期：2015年第3卷第2期

页      面：122-127页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：acute-on-chronic liver failure model for end-stage liver disease(MELD)score liver transplantation mortality 

摘      要：Background:Acute-on-chronic liver failure(ACLF)is characterised by a sudden deterioration of underlying chronic liver disease,resulting in increased rates of mortality and liver *** prognostication can benefit optimal allocation of ***:ACLF was defined as per the disease criteria of the Asian Pacific Association for the Study of the *** discharge summaries from between January 2001 and April 2013 were *** primary outcome was mortality or liver transplantation within 60 days from onset of ***‘model for end-stage liver disease’(MELD)score and change in MELD at Weeks 1,2 and 4 were reviewed in order to identify the earliest point for prediction of mortality or liver ***:Clinical data were collected on 53 subjects who fulfilled the inclusion and exclusion *** 60 days from presentation,20 patients(37.7%)died and 4(7.5%)underwent liver *** MELD of-2 after 2 weeks was 75.0%sensitive and 75.9%specific for predicting mortality or liver *** the MELD score did not increase at 2 weeks,predictive chance of survival was 93.8%over the next 60 *** change at 1 week showed poor sensitivity and *** at 4 weeks was too late for ***:Change in MELD score at 2 weeks provides an early opportunity for prognostication in ACLF.A MELD score that does not deteriorate by Week 2 would predict 93.8%chance of survival for the next 60 *** finding warrants further validation in larger cohort studies.