POSSIBILITIES OF USING MELD SCALE FOR DETERMINING HEPATIC CIRRHOSIS DEGREE OF SEVERITY

Abstract

Aim. To study the possibility of using MELD scale for determining the degree of severity of hepatic cirrhosis (HC) and determine its diagnostic characteristics.

Materials and methods. Thirty patients with HC, including 15 patients with compensated HC stage (class A+B) by Child-Pugh scale and 15 persons with decompensated HC (class C), were examined. Total blood bilirubin and creatinine concentrations were assessed, INR and MELD index were calculated.

Results. Meld index with use of total bilirubin, creatinine indices and INR is increasing as HC is progressing from 5 at the compensated stage to 26 at the decompensated stage ( p < 0,001) and directly correlates with the degree of severity of cirrhosis, estimated by Child-Pugh scale ( r = 0,64; p = 0,005). The threshold value of MELD index to differentiate the compensated HC stage from the decompensated one was 11.

Conclusions. Design parameter of MELD permits to differentiate the degrees of HC severity with sensitivity equal to 73,3 % and specificity - 84,6 %. When MELD index is less than or equal to 11, the compensated stage of HC is diagnosed, when it exceeds 11, the decompensated cirrhosis is specified.

Keywords

Hepatic cirrhosis / cirrhosis degree of severity / MELD scale / Child-Pugh scale

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RIGHTS & PERMISSIONS

Paducheva S.V., Bulatova I.A., Schekotova A.P., Tretyakova Y.I., Schekotova I.V.