![]() ![]() Another drawback of MELD is that it gives maximum weightage for INR which vary with time to time even in same patient. The problem with MELD is that creatinine (one component of MELD) may vary according to muscle mass, and its levels in females were less compared to males leading to increased mortality of females in transplantation list. But later, it was found to be effective for allocating organs for transplantation candidates based on MELD score. MELD was introduced by Malinchoc for TIPSS patients. Among them, the most important was MELD and MELD variants. Many scoring systems were proposed for better allocation of organ for transplantation and to decrease the mortality in transplant waiting list. Many studies have investigated factors predicting survival in patients with cirrhosis. Because of scarcity of cadaveric donors, identification of most suitable recipients who requires the transplantation is at most important. Liver transplantation is the only curative therapy for DCLD. Though many therapies for DCLD had been tried, most of them were not able to provide a curative therapy. With emergence of NAFLD, the incidence of DCLD is increasing at an alarming rate. It can be calculated at bedside as it is a simple score with no logarithmic variables in it.ĭecompensated liver disease (DCLD) is one of the most common cause of mortality worldwide, though the etiology varies from place to place. ConclusionĬHIBA score is superior to MELD and MELD variants in predicting 3-month mortality, and it is validated in an external cohort. At a cutoff of > 5.5, it has a sensitivity of 60% and specificity of 77%. For validation, 214 patients were selected, and AUROC of CHIBA score in the validation cohort was 0.77. ResultsĬHIBA score has AUROC of 0.793 (at a cutoff of > 5.5, it has a sensitivity of 66% and specificity of 76%) compared to MELD-Na of 0.735 (cutoff > 25, sensitivity 65%, and specificity 72%) MELD of 0.727 (cutoff > 17 sensitivity of 80.37% and specificity of 55.14%) I-MELD of 0.72 MESO index of 0.72 and UKELD of 0.686. Logistic regression was done, coefficient of beta of independent variables were found out, and a new CHIBA score was proposed.ĬHIBA score = creatinine × 0.6 + HE × 0.4+ INR × 0.8 + bilirubin × 0.125 + ascites × 1.2) where C stands for creatinine, H for hepatic encephalopathy, I for INR, B for bilirubin, and A for ascites. Patient relatives were telephonically contacted regarding date of death, and mortality at 3 months was assessed. Retrospective study with 321 DCLD patients were enrolled. The aim of the study is to propose a new prognostic model for DCLD which is better than the existing scores. MELD, MELD variants, and CTP were widely tested for mortality prediction with few drawbacks. ![]() Decompensated liver disease (DCLD) has high mortality, and its prediction is important to prognosticate and prioritize patients for liver transplantation. ![]()
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