In patients undergoing surgery, Child–Pugh score had a higher specificity than MELD score. In patients admitted to ICU, MELD score had a smaller negative likelihood ratio and a higher sensitivity than Child–Pugh score. In patients with acute-on-chronic liver failure, Child–Pugh score had a higher sensitivity and a lower specificity than MELD score. Forty-two papers were further included in the meta-analysis. They included 269 comparisons, of which 44 favored MELD score, 16 favored Child–Pugh score, 99 did not find any significant difference between them, and 110 did not report the statistical significance.
Study population was heterogeneous among studies. Of the 1095 papers initially identified, 119 were eligible for the systematic review. The summary areas under receiver operating characteristic curves, sensitivities, specificities, positive and negative likelihood ratios, and diagnostic odds ratios were also calculated. The statistical results were summarized from every individual study. PubMed and EMBASE databases were searched. A systematic review and meta-analysis aimed to compare the discriminative ability of Child–Pugh versus MELD score to assess the prognosis of cirrhotic patients. Ĭhild–Pugh and MELD scores have been widely used for the assessment of prognosis in liver cirrhosis.
#MELD SCORE PROGNOSIS PDF#
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This study was partially supported by the grant from the National Natural Science Foundation of China (no. All authors have made an intellectual contribution to the manuscript and approved the submission. XQ: conceived the study, performed the literature search and selection, data extraction, quality assessment, and statistical analysis, and drafted the manuscript YP: performed the literature search and selection, data extraction, quality assessment, and statistical analysis XG: gave critical comments and revised the manuscript. YP and XQ contributed equally to this work. 83 Wenhua Road, Shenyang 110840, China (e-mail:, ).Ībbreviations: ACLF = acute-on-chronic liver failure, AUSROC = summary areas under receiver operating characteristic curve, CI = confidence interval, DOR = diagnostic odds ratio, HCC = hepatocellular carcinoma, HE = hepatic encephalopathy, ICU = intensive care unit, INR = international normalized ratio, LT = liver transplantation, MELD = model for end-stage liver disease, NLR = negative likelihood ratio, PLR = positive likelihood ratio, QUADAS = Quality Assessment of Diagnostic Accuracy Studies, SE = standard error, TIPS = transjugular intrahepatic portosystemic shunts. From the Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang (YP, XQ, XG) and Postgraduate College, Dalian Medical University, Dalian, China (YP).Ĭorrespondence: Xiaozhong Guo, Xingshun Qi, Department of Gastroenterology, General Hospital of Shenyang Military Area, No.
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