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

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World Journal of Gastroenterology 2008年第11期14卷 1774-1780页

作者： Maarouf A Hoteit Amaar H Ghazale Andrew J Bain Eli S Rosenberg kirk a easley Frank A Anania Robin E Rutherford Division of Digestive Diseases Emory UniversityAtlanta GeorgiaUnited States Department of Internal Medicine Emory UniversityAtlantaGeorgiaUnited States Department of Biostatistics-Rollins School of Public Health Emory UniversityAtlanta GeorgiaUnited States

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.

关键词：肝硬化预后手术治疗外科规程并发症

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