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Liver transplantation in patients with hepatic hydrothorax.pdf

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Liver transplantation in patients with hepatic hydrothorax

Int J Clin Exp Med 2015;8(1):751-757 /ISSN:1940-5901/IJCEM0003706 Original Article Child-Pugh versus MELD score for predicting the in-hospital mortality of acute upper gastrointestinal bleeding in liver cirrhosis Ying Peng*, Xingshun Qi*, Junna Dai, Hongyu Li, Xiaozhong Guo Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, 83 Wenhua Road, Shenyang 110840, China. *Equal contributors. Received November 8, 2014; Accepted January 9, 2015; Epub January 15, 2015; Published January 30, 2015 Abstract: A retrospective study was conducted to compare the performance of Child-Pugh and Model for End-Stage Liver Diseases (MELD) scores for predicting the in-hospital mortality of acute upper gastrointestinal bleeding (UGIB) in patients with liver cirrhosis. A total of 145 patients with a diagnosis of liver cirrhosis and acute UGIB between July 2013 and June 2014 were retrospectively analyzed (male/female: 94/51; mean age: 56.77±11.33 years; Child-Pugh class A/B/C: 46/64/35; mean Child-Pugh score: 7.88±2.17; mean MELD score: 7.86±7.22). The in- hospital mortality was 8% (11/145). Areas under receiving-operator characteristics curve (AUROC) for predicting the in-hospital mortality were compared between MELD and Child-Pugh scores. AUROCs for predicting the in-hospital mortality for Child-Pugh and MELD scores were 0.796 (95% confidence interval [CI]: 0.721-0.858) and 0.810 (95% CI: 0.736-0.870), respectively. The discriminative ability was not significant different between the two scoring sys- tems (P=0.7241). In conclusion, Child-Pugh and MELD scores were similar for predicting the in-hospital mortality of acute UGIB in cirrhotic patients. Keywords: Liver cirrhosis, gastrointestinal bleeding, Child-Pugh, MELD, prognosis Introduction Child-Pugh classification, including total biliru- bin, albumin, international normalized ratio (INR) or prothrombin time, hepatic encephalop- athy, and ascites, is the most commonly used