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Serum sodium based modification of the MELD does not improve prediction of outcome in acute liver failure
BACKGROUND: Acute liver failure (ALF) is a devastating clinical syndrome with a high mortality rate. The MELD score has been implied as a prognostic tool in ALF. Hyponatremia is associated with lethal outcome in ALF. Inclusion of serum sodium (Na) into the MELD score was found to improve its predict...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3637827/ https://www.ncbi.nlm.nih.gov/pubmed/23551795 http://dx.doi.org/10.1186/1471-230X-13-58 |
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author | Manka, Paul Bechmann, Lars P Tacke, Frank Sowa, Jan-Peter Schlattjan, Martin Kälsch, Julia Jochum, Christoph Paul, Andreas Saner, Fuat H Trautwein, Christian Gerken, Guido Canbay, Ali |
author_facet | Manka, Paul Bechmann, Lars P Tacke, Frank Sowa, Jan-Peter Schlattjan, Martin Kälsch, Julia Jochum, Christoph Paul, Andreas Saner, Fuat H Trautwein, Christian Gerken, Guido Canbay, Ali |
author_sort | Manka, Paul |
collection | PubMed |
description | BACKGROUND: Acute liver failure (ALF) is a devastating clinical syndrome with a high mortality rate. The MELD score has been implied as a prognostic tool in ALF. Hyponatremia is associated with lethal outcome in ALF. Inclusion of serum sodium (Na) into the MELD score was found to improve its predictive value in cirrhotic patients. Therefore the aim of this study was to determine whether inclusion of serum Na improves the predictive value of MELD in ALF compared to established criteria. METHODS: In a prospective single center study (11/2006–12/2010), we recruited 108 consecutive ALF patients (64% females / 36% males), who met the criteria defined by the “Acute Liver Failure Study Group Germany”. Upon admission, clinical and laboratory data were collected, King’s College Criteria (KCC), Model of End Stage Liver Disease score (MELD), and serum sodium based modifications like the MELD-Na score and the United Kingdom Model of End Stage Liver Disease score (UKELD) were calculated and area under the receiver operating characteristic curve analyses were performed regarding the prediction of spontaneous recovery (SR) or non-spontaneous recovery (NSR; death or transplantation). RESULTS: Serum bilirubin was of no prognostic value in ALF, and Na also failed to predict NSR in ALF. The classical MELD score was superior to sodium-based modifications and KCC. CONCLUSIONS: We validated the prognostic value of MELD-Na and UKELD in ALF. Classic MELD score calculations performed superior to KCC in the prediction of NSR. Serum Na and Na-based modifications of MELD did not further improve its prognostic value. |
format | Online Article Text |
id | pubmed-3637827 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-36378272013-05-01 Serum sodium based modification of the MELD does not improve prediction of outcome in acute liver failure Manka, Paul Bechmann, Lars P Tacke, Frank Sowa, Jan-Peter Schlattjan, Martin Kälsch, Julia Jochum, Christoph Paul, Andreas Saner, Fuat H Trautwein, Christian Gerken, Guido Canbay, Ali BMC Gastroenterol Research Article BACKGROUND: Acute liver failure (ALF) is a devastating clinical syndrome with a high mortality rate. The MELD score has been implied as a prognostic tool in ALF. Hyponatremia is associated with lethal outcome in ALF. Inclusion of serum sodium (Na) into the MELD score was found to improve its predictive value in cirrhotic patients. Therefore the aim of this study was to determine whether inclusion of serum Na improves the predictive value of MELD in ALF compared to established criteria. METHODS: In a prospective single center study (11/2006–12/2010), we recruited 108 consecutive ALF patients (64% females / 36% males), who met the criteria defined by the “Acute Liver Failure Study Group Germany”. Upon admission, clinical and laboratory data were collected, King’s College Criteria (KCC), Model of End Stage Liver Disease score (MELD), and serum sodium based modifications like the MELD-Na score and the United Kingdom Model of End Stage Liver Disease score (UKELD) were calculated and area under the receiver operating characteristic curve analyses were performed regarding the prediction of spontaneous recovery (SR) or non-spontaneous recovery (NSR; death or transplantation). RESULTS: Serum bilirubin was of no prognostic value in ALF, and Na also failed to predict NSR in ALF. The classical MELD score was superior to sodium-based modifications and KCC. CONCLUSIONS: We validated the prognostic value of MELD-Na and UKELD in ALF. Classic MELD score calculations performed superior to KCC in the prediction of NSR. Serum Na and Na-based modifications of MELD did not further improve its prognostic value. BioMed Central 2013-04-03 /pmc/articles/PMC3637827/ /pubmed/23551795 http://dx.doi.org/10.1186/1471-230X-13-58 Text en Copyright © 2013 Manka et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Manka, Paul Bechmann, Lars P Tacke, Frank Sowa, Jan-Peter Schlattjan, Martin Kälsch, Julia Jochum, Christoph Paul, Andreas Saner, Fuat H Trautwein, Christian Gerken, Guido Canbay, Ali Serum sodium based modification of the MELD does not improve prediction of outcome in acute liver failure |
title | Serum sodium based modification of the MELD does not improve prediction of outcome in acute liver failure |
title_full | Serum sodium based modification of the MELD does not improve prediction of outcome in acute liver failure |
title_fullStr | Serum sodium based modification of the MELD does not improve prediction of outcome in acute liver failure |
title_full_unstemmed | Serum sodium based modification of the MELD does not improve prediction of outcome in acute liver failure |
title_short | Serum sodium based modification of the MELD does not improve prediction of outcome in acute liver failure |
title_sort | serum sodium based modification of the meld does not improve prediction of outcome in acute liver failure |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3637827/ https://www.ncbi.nlm.nih.gov/pubmed/23551795 http://dx.doi.org/10.1186/1471-230X-13-58 |
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