scholarly journals Correlation of aspartate aminotransferase-to-platelet ratio index with child-turcotte-Pugh score and model for end stage liver disease score in patients of liver cirrhosis

2021 ◽  
Author(s):  
Princi Jain ◽  
Yatish Agarwal ◽  
Bijender Kumar Tripathi ◽  
Anil Kumar Jain ◽  
Divesh Jalan ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Aspartate Aminotransferase ◽  
Pearson Correlation ◽  
Meld Score ◽  
End Stage Liver Disease ◽  
Normal Platelet ◽  
Severity Scores ◽  
Ctp Score ◽  
End Stage

Background: Though liver biopsy is considered to be a gold standard for the diagnosis and severity of liver cirrhosis, recently many non-invasive markers have come up for the same. In the current study, we investigated the correlation of aspartate aminotransferase-to-platelet ratio index with other severity scores of liver cirrhosis namely child-turcotte-Pugh score and model for end stage liver disease score.Methods: Fifty-one patients with cirrhosis, identified on the basis of abdomen ultrasonographic findings were enrolled in the study. APRI was calculated for every patient using the formula, (AST/upper limit of normal/platelet count;109/l)×100. The MELD score was calculated according to the original formula proposed by the Mayo clinic group: 3.8×loge (bilirubin; mg/dl)+11.2×loge(INR)+ 9.6×loge (creatinine; mg/dl)+6.4. CTP scoring was calculated based on the severity of hepatic encephalopathy, ascites, total bilirubin, albumin, and INR. Correlation of APRI with MELD and CTP score was established using Pearson correlation coefficient.Results: APRI scores correlated well with the severity of the cirrhosis. With the progression of the CTP class from A to C and with increase in the MELD score, increase in the APRI index was also observed.Conclusions: APRI showed positive correlation with CTP and MELD score.

scholarly journals Creatinine-modified Child-Turcotte-Pugh score is a good predictor of a short-term survival in patients with bleeding from esophageal varices

2017 ◽  
Vol 74 (1) ◽  
pp. 13-18
Author(s):  
Mirjana Radisavljevic ◽  
Goran Bjelakovic ◽  
Jasna Jovic ◽  
Biljana Radovanovic-Dinic ◽  
Danijela Benedeto-Stojanov ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Esophageal Varices ◽  
Meld Score ◽  
Prognostic Scores ◽  
Short Term ◽  
End Stage Liver Disease ◽  
Ctp Score ◽  
End Stage

Background/Aim. Bleeding from esophageal varices is a significant factor in mortality of patients with terminal liver cirrhosis. This complication is a major health problem for recipients on the list for liver transplant. In that regard, studying predictors of variceal bleeding episode is very important. Also, it is important to find the best survival predictor among prognostic scores. The aim of the study was to compare validity of prognostic scores in assessment of survival in hospital-treated patients after bleeding from esophageal varices, and to compare validity of baseline Child-Turcotte-Pugh (CTP) and Modul for End-stage Liver Disease (MELD) scores with CTP creatinine modified (CTP-crea) I and II scores in assessment of survival in patients within a long-term follow-up period after the episode of bleeding from esophageal varices. Methods. The study included a total of 126 patients suffering from terminal liver cirrhosis submited to testing CTP score score I and II, MELD score, MELD Na score, integrated MELD score, MELD sodium (MESO) index, United Kingdom Model for End-Stage Liver Disease (UKELD) score and updated MELD score. Results. Patients with bleeding from esophageal varices most often had CTP score rank C (46,9%). CTP score rank B had 37.5% patients, while the smallest percentage of patients had CTP rank A, 15.6% of them. Patients who have values of CTP score higher than 10.50 and bleeding from esophagus, have 3.2 times higher chance for death outcome compared to other patients. Patients who have values of CTP-crea I score higher than 10.50 and bleeding from esophagus, have 3.1 times higher chance for death out-come than other patients. Patients who have values of CTP-crea II score higher than 11.50 and bleeding from esophagus, have 3,7 times higher chance for death outcome compared to other patients. Conclusion. Survival of patients with bleeding from esophageal varices in the short-term follow up can be predicted by following CTP score and creatinine modified CTP scores. Patients with bleeding from esophageal varices who have CTP score and CTP-crea I score higher than 10.5 and CTP-crea II score higher than 11.5, have statistically significantly higher risk from mortality within one-month follow-up compared to patients with bleeding from esophageal varices who have lower numerical values of scores of the CTP group.

scholarly journals Doppler ultrasound in liver cirrhosis: correlation of hepatic artery and portal vein measurements with model for end-stage liver disease score in Egypt

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Ahmed Abdelrahman Mohamed Baz ◽  
Rana Magdy Mohamed ◽  
Khaled Helmy El-kaffas
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Meld Score ◽  
Hepatic Decompensation ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
Us Findings ◽  
End Stage

Abstract Background Liver cirrhosis is a multi-etiological entity that alters the hepatic functions and vascularity by varying grades. Hereby, a cross-sectional study enrolling 100 cirrhotic patients (51 males and 49 females), who were diagnosed clinically and assessed by model for end-stage liver disease (MELD) score, then correlated to the hepatic Doppler parameters and ultrasound (US) findings of hepatic decompensation like ascites and splenomegaly. Results By Doppler and US, splenomegaly was evident in 49% of patients, while ascites was present in 44% of them. Increased hepatic artery velocity (HAV) was found in70% of cases, while 59% showed reduced portal vein velocity (PVV). There was a statistically significant correlation between HAV and MELD score (ρ = 0.000), but no significant correlation with either hepatic artery resistivity index (HARI) (ρ = 0.675) or PVV (ρ =0.266). Moreover, HAV had been correlated to splenomegaly (ρ = 0.000), whereas HARI (ρ = 0.137) and PVV (ρ = 0.241) did not significantly correlate. Also, ascites had correlated significantly to MELD score and HAV (ρ = 0.000), but neither HARI (ρ = 0.607) nor PVV (ρ = 0.143) was significantly correlated. Our results showed that HAV > 145 cm/s could confidently predict a high MELD score with 62.50% and 97.62 % sensitivity and specificity. Conclusion Doppler parameters of hepatic vessels (specifically HAV) in addition to the US findings of hepatic decompensation proved to be a non-invasive and cost-effective imaging tool for severity assessment in cirrhotic patients (scored by MELD); they could be used as additional prognostic parameters for improving the available treatment options and outcomes.

The Risk Of Surgery In Patients With Liver Disease 2

2018 ◽  
Author(s):  
Adrian Reuben
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Venous Pressure ◽  
Portal Pressure ◽  
Disease Patient ◽  
Case Series ◽  
Meld Score ◽  
End Stage Liver Disease ◽  
Ctp Score ◽  
End Stage

The results of retrospective largescale registry and cohort studies and small case series, substantiate the common perception that operating on a liver disease patient is risky. The preexisting physiological derangements of liver disease may be exacerbated by the trauma of surgery and its complications, which contributes strongly to the aforementioned surgical risks, especially but not exclusively in cirrhotics. The risks of operating on patients with non-cirrhotic liver disease are reviewed with particular emphasis on the poor outcomes in acute hepatitis—especially alcoholic hepatitis—severe fatty liver disease, and obstructive jaundice. The outcomes of a broad spectrum of surgical procedures in cirrhotics (abdominal, cardiothoracic, orthopedic, vascular, etc.) are reviewed, with particular reference to common predictors of survival and morbidity, such as the Child-Turcotte-Pugh (CTP) score/class and the model for end-stage liver disease (MELD) score. The concept is proposed that the height of portal pressure may be a predictive factor of surgical outcome, which derives from experience with hepatic resection and suggests that measurement of hepatic venous pressures may be worthwhile in selected cases. New, non-invasive estimates of liver function are presented. A simple practical pre-operative decision tree is provided. This review contains 5 figures, 3 tables and 91 references Keywords: cirrhosis, fatty liver, hepatic venous pressure gradient, hepatitis, model for end-stage liver disease, operative mortality, portal hypertension, Child-Turcotte-Pugh  

A Study on Haematological Manifestations in Patients with Chronic Liver Disease in a Tertiary Care Hospital of North India

2021 ◽  
Vol 8 (25) ◽  
pp. 2222-2228
Author(s):  
Jasmine Kaur ◽  
Navjot Kaur ◽  
Jasleen Kaur ◽  
Navjot Kaur Layal ◽  
Gurkiran Kaur
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Prothrombin Time ◽  
Chronic Liver Disease ◽  
Tertiary Care ◽  
Meld Score ◽  
Chronic Liver ◽  
Care Hospital ◽  
End Stage Liver Disease ◽  
End Stage

BACKGROUND Chronic liver diseases frequently are associated with haematological abnormalities. Anaemia occurs in about 75% of patients with chronic liver disease. The most common type of anaemia seen in liver cirrhosis is normocytic normochromic anaemia, due to the chronic inflammatory state, blood loss from oesophageal and rectal varices. The purpose of this study was to study the haematological manifestations in patients with chronic liver disease. METHODS A cross-sectional observational study was conducted at Sri Guru Ram Das Institute of Medical Sciences and Research (March 2019 - March 2020). Total of 90 patients with chronic liver disease were included in the study. The population was divided into 2 groups based on the model for end-stage liver disease (MELD) score and the various haematological abnormalities were assessed in these 2 groups. Similarly, haemoglobin (Hb) levels were assessed in 3 groups based on the ChildTurcotte-Pugh (CTP) classification. RESULTS There was a significant correlation between hemoglobina and CTP class (P < 0.001), with the lowest haemoglobin levels in CTP class C group. The correlation coefficient of MELD score and haemoglobin was -0.504 which was significant statistically. Thus, confirming the fact that haemoglobin levels decreases with the progress in the severity of liver cirrhosis. Of 39 patients with haemoglobin < 8 g/dl, 5 (12.8 %) had a MELD score of < 12, whereas 34 patients (87.2 %) had a MELD score of > 12 and was statistically significant (P < 0.0001). Leukocytosis was observed in 41 patients and leucopoenia in 14 patients. The mean prothrombin time was 20.4 seconds and 80 % of the patients had prothrombin time prolonged by more than 6 sec indicating liver damage alters coagulation profile. CONCLUSIONS We found an association between anaemia and indicators of advanced liver disease such as a higher MELD and CPS scores. This study inferred that levels of haemoglobin decrease as the severity of liver disease progresses. Thus, this measure can be used in the initial assessment of cirrhosis patients that needs urgent identification and correction to reduce morbidity and mortality. KEYWORDS Anaemia, Liver Cirrhosis, Model for End-Stage Liver Disease Score, Child-TurcottePugh Class

The Risk Of Surgery In Patients With Liver Disease 2

2018 ◽  
Author(s):  
Adrian Reuben
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Venous Pressure ◽  
Portal Pressure ◽  
Disease Patient ◽  
Case Series ◽  
Meld Score ◽  
End Stage Liver Disease ◽  
Ctp Score ◽  
End Stage

The results of retrospective largescale registry and cohort studies and small case series, substantiate the common perception that operating on a liver disease patient is risky. The preexisting physiological derangements of liver disease may be exacerbated by the trauma of surgery and its complications, which contributes strongly to the aforementioned surgical risks, especially but not exclusively in cirrhotics. The risks of operating on patients with non-cirrhotic liver disease are reviewed with particular emphasis on the poor outcomes in acute hepatitis—especially alcoholic hepatitis—severe fatty liver disease, and obstructive jaundice. The outcomes of a broad spectrum of surgical procedures in cirrhotics (abdominal, cardiothoracic, orthopedic, vascular, etc.) are reviewed, with particular reference to common predictors of survival and morbidity, such as the Child-Turcotte-Pugh (CTP) score/class and the model for end-stage liver disease (MELD) score. The concept is proposed that the height of portal pressure may be a predictive factor of surgical outcome, which derives from experience with hepatic resection and suggests that measurement of hepatic venous pressures may be worthwhile in selected cases. New, non-invasive estimates of liver function are presented. A simple practical pre-operative decision tree is provided. This review contains 5 figures, 3 tables and 91 references Keywords: cirrhosis, fatty liver, hepatic venous pressure gradient, hepatitis, model for end-stage liver disease, operative mortality, portal hypertension, Child-Turcotte-Pugh  

scholarly journals Evaluation of Mortality Risk in Liver Cirrhosis with Albumin- Bilirubin (Albi), Platelet-Albumin-Bilirubin (Palbi), and Fibrosis-4 (Fib-4) Scores

2021 ◽  
Vol 14 (02) ◽  
pp. 985-991
Author(s):  
D.A. Sindhughosa ◽  
I.K. Mariadi ◽  
I.D.N. Wibawa ◽  
I.G.A. Suryadarma ◽  
N. Purwadi ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Mortality Risk ◽  
Liver Diseases ◽  
Cross Sectional Study ◽  
Meld Score ◽  
Sectional Study ◽  
Cross Sectional ◽  
End Stage Liver Disease ◽  
End Stage

Background:The model for end stage liver disease (MELD) score considered as a reliable predictor of survival for advanced liver diseases patients. Among several chemistry laboratorium examinations, albumin, bilirubin and platelet reflect the function of the liver. Objectives: To investigate the correlation of albumin-bilirubin (ALBI), platelet-albumin-bilirubin (PALBI), and fibrosis-4 (FIB-4) scores with mortality risk based on MELD score and evaluate their role in predictingcirrhosis mortality risk. Methods: The analytic cross-sectional study designrecruited adults with liver cirrhosis of any etiology during the period of November 2018 through January 2019. Descriptive and correlative analyses were done before proceeding to diagnostic abilityanalysis. Results: Sixty-two patients with mean age of 52.95 ± 12.05 were included in the analysis. The ALBI, PALBI, and FIB-4 scores were significantly correlated with higher mortality risk based on MELD score. The three scoressignificantly predicted higher mortality risk with varying sensitivity and specificity. Conclusion: Positivecorrelation between ALBI, PALBI, and FIB-4 scores with MELD score was found. ALBI (≥-1.26), PALBI (≥-2.05), and FIB-4 (≥5.84) values higher than the thresholdcould predict mortality risk in cirrhosis.

scholarly journals The model for the end-stage liver disease and Child-Pugh score in predicting prognosis in patients with liver cirrhosis and esophageal variceal bleeding

2009 ◽  
Vol 66 (9) ◽  
pp. 724-728 ◽  
Author(s):  
Daniela Benedeto-Stojanov ◽  
Aleksandar Nagorni ◽  
Goran Bjelakovic ◽  
Dragan Stojanov ◽  
Bojan Mladenovic ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Survival Rate ◽  
Variceal Bleeding ◽  
Meld Score ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
End Stage

Background/Aim. Esophageal variceal bleeding is one of the most frequent and gravest complications of liver cirrhosis, directly life-threatening. By monitoring certain clinical and laboratory hepatocellular insufficiency parameters (Child-Pugh score), it is possible to determine prognosis in patients who are bleeding and evaluate further therapy. Recently, the Model for the End-Stage Liver Disease (MELD) has been proposed as a tool to predict mortality risk in cirrhotic patients. The aim of the study was to evaluate survival prognosis of cirrhotic patients by the MELD and Child-Pugh scores and to analyze the MELD score prognostic value in patients with both liver cirrhosis and variceal bleeding. Methods. We retrospectively evaluated the survival rate of a group of 100 cirrhotic patients of a median age of 57 years. The Child-Pugh score was calculated and the MELD score was computed according to the original formula for each patient. We also analyzed clinical and laboratory hepatocellular insufficiency parameters in order to examine their connection with a 15-month survival. The MELD values were correlated with the Child-Pugh scores. The Student's t-test was used for statistical analysis. Results. Twenty-two patients died within 15-months follow-up. Age and gender did not affect survival rate. The Child- Pugh and MELD scores, as well as ascites and encephalopathy significantly differed between the patients who survived and those who died (p < 0.0001). The International Normalized Ratio (INR) values, serum creatinine and bilirubin were significantly higher, and albumin significantly lower in the patients who died (p < 0.0001). The MELD score was significantly higher in the group of patients who died due to esophageal variceal bleeding (p < 0.0001). Conclusion. In cirrhotic patients the MELD score is an excellent survival predictor at least as well as the Child-Pugh score. Increase in the MELD score is associated with decrease in residual liver function. In the group of patients with liver cirrhosis and esophageal variceal bleeding, the MELD score identifies those with a higher intrahospital mortality risk.

scholarly journals STUDY THE RELATION BETWEEN SERUM SODIUM AND THE MODEL FOR END-STAGE LIVER DISEASE SCORE IN PATIENTS WITH LIVER CIRRHOSIS

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Dhawal Vyas
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Serum Sodium ◽  
Meld Score ◽  
Disease Score ◽  
Medical College ◽  
End Stage Liver Disease ◽  
Advanced Cirrhosis ◽  
Pugh Class ◽  
End Stage

Background: The aim of the study was to evaluate the prevalence of hyponatremia in liver cirrhosis and the correlation between serum sodium and the Model for End-Stage Liver Disease (MELD) score in patients with liver cirrhosis. Methods: We prospectively collected data of 200 patients of chronic liver disease hospitalized in medical and surgical gastroenterology department of Geetanjali medical college, Udaipur. Results: Serum sodium values were strongly associated with severity of cirrhosis, assessed by child Pugh class and MELD score. There was significant relationship between serum sodium, renal function (as assessed by serum creatinine) Conclusion: Hyponatremia is a common problem in liver cirrhosis, especially advanced cirrhosis. The study showed that there is an association between hyponatremia and the presence of certain complications of liver cirrhosis. Also hyponatremia was associated with a higher severity of cirrhosis assessed by MELD scores.  Keywords: hyponatrenia, Liver cirrhosis, MELD score

scholarly journals Child-Turcotte-Pugh and Model for End-Stage Liver Disease Scores: Accuracy of Predictability for Mortality in Acute Variceal Hemorrhage

2021 ◽  
Vol 2 (1) ◽  
pp. 8
Author(s):  
Kazim Abbas Virk ◽  
Sana Tahir Virk ◽  
Inayt Adil ◽  
Shiza Tahir Virk ◽  
Haseeb Noor ◽  
...  
Keyword(s):  
Liver Disease ◽  
Diagnostic Accuracy ◽  
Positive Likelihood Ratio ◽  
Mean Value ◽  
Meld Score ◽  
Variceal Hemorrhage ◽  
End Stage Liver Disease ◽  
The Mean ◽  
Ctp Score ◽  
End Stage

Objective: To determine a score that best predicts the mortality of admitted patients within six weeks of Acute Variceal Hemorrhage (AVH).Study Design: Cross sectional study.Place and Duration of Study: The study was conducted at Inpatient Department of Gastroenterology Unit at Pakistan Institute of Medical Sciences (PIMS), Islamabad for six months.Materials and Methods: The number of patients with AVH enrolled in this study were 223. A pretested questionnaire was used to gather the required information; Model for End-stage Liver Disease (MELD) and Child-Turcotte-Pugh (CTP) scores of each patient were recorded at the time of admission in the inpatient facility. The outcome was documented via a telephonic call at the end of six weeks. The primary outcome of the study was “mortality” at end of six weeks.Results: The total number of participants were 223, including 61% (n=136) males and 39% (n=87) females. The mean age was 52.4±13.96. The overall mean value of CTP score was 9.6±2.8 and mean value of MELD score was 19.3±6.7, while the mean values of CTP and MELD among non-survivors were 12.9±2.1 and 26.6±5.6, respectively. After six weeks, the number of deaths were 27% (n=60). The MELD had positive predictive value (PPV) of 83.3%, negative predictive value (NPV) of 96.8%, sensitivity: 91.7%, specificity: 93.3%, diagnostic accuracy: 92.82%, and positive likelihood ratio of 13.68. Similarly, CTP had PPV: 77.4%, NPV: 92.5%, sensitivity: 80%, specificity: 91.4%, diagnostic accuracy: 88.34% and positive likelihood ratio of 9.3. The area under the curve (AUC)for MELD was 0.91, while CTP was 0.90.Conclusion: The MELD score is better in its discriminative ability and more accurate in predicting six weeks mortality in patients with AVH than CTP score.

scholarly journals Hypothalamic-pituitary-gonadal function in men with liver cirrhosis before and after liver transplantation

2014 ◽  
Vol 41 (6) ◽  
pp. 421-425 ◽  
Author(s):  
Bruno T. Zacharias ◽  
Julio C. U. Coelho ◽  
Mônica B. Parolin ◽  
Jorge E. F. Matias ◽  
Alexandre C. T. de Freitas ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Cirrhosis ◽  
Liver Disease ◽  
Serum Levels ◽  
Meld Score ◽  
Male Hypogonadism ◽  
End Stage Liver Disease ◽  
Before And After ◽  
Male Patients ◽  
End Stage

Objective: To evaluate the influence of end-stage liver disease and orthotopic liver transplantation in the pituitary function and hormone metabolism before and after liver transplantation.Methods: In a prospective study, serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and prolactin (PRL) of 30 male patients with cirrhosis were determined two to four hours before and six months after liver transplantation. The results were compared according to the Model for End-stage Liver Disease (MELD).Results: male patients with liver cirrhosis have hypogonadism. FSH was normal, but inappropriately low due to androgen failure; E2 and PRL, on their turn, were high. After liver transplantation, FSH and LH levels increased (p < 0.05), whereas E2 and PRL normalized (p < 0.05). The MELD score did not influence changes in FSH, PRL and LH, however, the more severe the cirrhosis was, the more significant was the normalization of E2 (p = 0.01).Conclusion: Patients with cirrhosis and male hypogonadism have inappropriately normal levels of FSH and LH, associated with an increase in E2 and LRP. After liver transplantation, FSH and LH increased, while E2 and PRL returned to normal. Changes in E2 levels were most pronounced in patients with MELD > 18. The severity of cirrhosis had no influence on FSH, PRL and LH.

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