Impacts of Prognostic Scores on Short Term Mortality in Liver Cirrhotic Patients with Hepatorenal Syndrome

Erhan Ergin; Rukiye Vardar; Omer Ozutemiz

Volume : VII, Issue : III, March - 2018

Impacts of Prognostic Scores on Short Term Mortality in Liver Cirrhotic Patients with Hepatorenal Syndrome

Erhan Ergin, Rukiye Vardar, Omer Ozutemiz

Abstract :

Background/Aims: This study was designed to evaluate the role of new scoring systems which are recommended for predicting of mortality in end–stage liver disease, and in predicting short–term prognosis of Hepatorenal Syndrome (HRS).

Material and Methods: A total of 380 patients, were retrospectively investigated using medical records.New scoring systems continue to be developed using various mathematical formulas obtained by combining Model for end–stage liver disease (MELD) score with Na: Model for end–stage liver disease with incorporation of serum sodium (MELD–Na, MELDNa), changes of MELD–Na on day 14 of the medical therapy MELD–Na (Delta MELD–Na), the integrated MELD (iMELD), The United Kingdom Model for End–Stage Liver Disease (UKELD), Update MELD, MELD to Na ratio (MESO).

Results: Forty four of 380 liver cirrhosis patients were diagnosed with HRS. There were 25 patients with type 1 HRS and 19 patients with type 2 HRS. As a post–treatment response, there was positive correlation between Child–Turcotte–Pugh (CTP) classification score, MELD, MELDNa, MELD–Na, iMELD, MESO, UKELD, and Updated MELD scores, whereas negative correlation between all scores and Delta MELD–Na for both type 1 and type 2 HRS. Mortality rate was significantly higher in type 1 HRS (68% (17/25)) than type 2 (31.5% (6/19)) HRS in the course of three months follow up period (p=0.01).All prognostic scores were significantly convenient for predicting three months survival in type 1 and type 2 HRS patients.

Conclusion: The present study has investigated short–term efficacy of currently recommended prognostic factors in liver cirrhosis with HRS; it was determined that dilutional hyponatremia and age have significant effect on short–term mortality.