COMPARISON OF MODEL FOR END-STAGE LIVER DISEASE-SODIUM SCORE & MODEL FOR END-STAGE LIVER DISEASE SCORE (MELD) IN PREDICTING IN-HOSPITAL MORTALITY IN PATIENTS WITH END-STAGE LIVER DISEASE: AN OBSERVATIONAL STUDY

Abstract

OBJECTIVES: To assess in-hospital mortality in patients with end-stage liver disease and evaluate its association with mean Model for End-Stage Liver Disease (MELD) and MELD-Na scores.

METHODOLOGY: This prospective cross-sectional study was executed at PUMHSW Nawabshah, comprising a sample of 189 participants aged from 18 to 65 years who were clinically diagnosed with end-stage liver disease. The subjects were monitored until their discharge, and an assessment of in-hospital mortality was conducted utilizing the MELD and MELD-Na scoring systems calculated upon admission. The acquired data underwent rigorous statistical analysis employing SPSS software, version 26, where a threshold level of significance was established at p ≤ 0.05.

RESULTS : The investigation encompassed a cohort of 189 individuals diagnosed with End-Stage Liver Disease (ESLD) (Mean age 48.86 ± 11.77 years), with 8% identified as male and 19% as female. Non-survivors exhibited significantly elevated Model for End-Stage Liver Disease (MELD) (29.46 ± 8.20) and MELD-Na (31.51 ± 8.17) scores in comparison to their survivor counterparts. Both MELD and MELD-Na scores demonstrated a robust correlation with in-hospital mortality (p=0.001 & p=0.005, respectively).

CONCLUSION: MELD and MELD-Na scoring systems serve as critical prognostic indicators of in-hospital mortality among individuals afflicted with end-stage liver disease. It was observed that non-survivors exhibited significantly elevated scores in comparison to their survivor counterparts, with MELD-Na demonstrating marginally superior predictive precision. The integration of these scoring systems at the point of hospital admission can facilitate early risk stratification, inform clinical decision-making processes, and enhance patient outcomes through timely medical interventions and the judicious allocation of healthcare resources.