GIÁ TRỊ CỦA THANG ĐIỂM CHILD PUGH, MELD VÀ MELDNA TRONG TIÊN LƯỢNG TỬ VONG Ở BỆNH NHÂN XƠ GAN MẤT BÙ DO VIÊM GAN VIRUS B

Abstract

To evaluate the prognostic value of the Child-Pugh, MELD, and MELDNa scores in patients with decompensated hepatitis B cirrhosis, we conducted a study in 149 patients with decompensated hepatitis B cirrhosis treated at the National hospital for Tropical diseases from August 2022 to July 2023. The patients were followed and mortality was evaluated within 90 days after admission. The study results showed that the mortality rates was 32.2%, respectively. The main causes of death were hepatic encephalopathy (58,3%), followed by gastrointestinal bleeding (20.8%), and infection (8.3%). The proportions of Child-Pugh class B and C were 45.6% and 47.7%, respectively; the group with MELD scores > 18 points accounted for 76.5%; the MELDNa groups with scores of 20-29 and 30-39 accounted for 40.3% and 36.9%, respectively. MELDNa had a better predictive value for mortality compared to MELD and Child-Pugh, with area under the curve (AUC) values of 0.732, 0.655, and 0.578, respectively. The optimal cutoff points for Child-Pugh, MELD, and MELDNa in predicting mortality were 8, 23, and 25, with sensitivities/specificities of 81.3%/37.6%; 68.8%/49.5% and 87.5%/47.5%, respectively.