A comparative analysis between Model for End-stage Liver Disease score (MELD), Modified Model for End-stage Liver Disease score (MELD-Na), and Child–Pugh score (CPS) in predicting complications among cirrhosis patients

Abstract Aim This study aims to compare the effectiveness of the model for end-stage liver disease (MELD), the modified model for end-stage liver disease including sodium (MELD-Na), and the Child–Pugh score (CPS) in predicting complications in patients with cirrhosis. Methods We conducted a prospect...

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Main Authors: Anagha Ravinath Naik, Swathy Moorthy
Format: Article
Language:English
Published: SpringerOpen 2025-07-01
Series:The Egyptian Journal of Internal Medicine
Subjects:
Online Access:https://doi.org/10.1186/s43162-025-00478-x
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author Anagha Ravinath Naik
Swathy Moorthy
author_facet Anagha Ravinath Naik
Swathy Moorthy
author_sort Anagha Ravinath Naik
collection DOAJ
description Abstract Aim This study aims to compare the effectiveness of the model for end-stage liver disease (MELD), the modified model for end-stage liver disease including sodium (MELD-Na), and the Child–Pugh score (CPS) in predicting complications in patients with cirrhosis. Methods We conducted a prospective and observational study, analyzing 145 cirrhotic patients admitted to a tertiary care teaching hospital. The predictive accuracies of MELD, MELD-Na, and CPS for complications such as ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome, varices, hepatocellular carcinoma, and hepatic hydrothorax were assessed using receiver operating characteristic (ROC) curves. Results The CPS was more accurate in predicting ascites (AUC = 0.753), while MELD and MELD-Na scores more reliably predicted hepatic encephalopathy and hepatorenal syndrome (AUCs from 0.734 to 0.834). None of the scoring systems was effective in predicting varices or hepatic hydrothorax, with AUCs approaching 0.5. Conclusion The CPS remains a robust predictor for ascites, and the MELD scores, particularly when sodium is included, are better for predicting hepatorenal syndrome and HCC. The limited utility of these scores for predicting varices and hepatic hydrothorax underscores the necessity for developing more sophisticated models or utilizing additional clinical parameters in prognostication.
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spelling doaj-art-fb5a56218ae24facb7ac3154bc93b05d2025-08-20T04:02:50ZengSpringerOpenThe Egyptian Journal of Internal Medicine2090-90982025-07-0137111010.1186/s43162-025-00478-xA comparative analysis between Model for End-stage Liver Disease score (MELD), Modified Model for End-stage Liver Disease score (MELD-Na), and Child–Pugh score (CPS) in predicting complications among cirrhosis patientsAnagha Ravinath Naik0Swathy Moorthy1Sri Ramachandra Institute of Higher Education and ResearchSri Ramachandra Institute of Higher Education and ResearchAbstract Aim This study aims to compare the effectiveness of the model for end-stage liver disease (MELD), the modified model for end-stage liver disease including sodium (MELD-Na), and the Child–Pugh score (CPS) in predicting complications in patients with cirrhosis. Methods We conducted a prospective and observational study, analyzing 145 cirrhotic patients admitted to a tertiary care teaching hospital. The predictive accuracies of MELD, MELD-Na, and CPS for complications such as ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome, varices, hepatocellular carcinoma, and hepatic hydrothorax were assessed using receiver operating characteristic (ROC) curves. Results The CPS was more accurate in predicting ascites (AUC = 0.753), while MELD and MELD-Na scores more reliably predicted hepatic encephalopathy and hepatorenal syndrome (AUCs from 0.734 to 0.834). None of the scoring systems was effective in predicting varices or hepatic hydrothorax, with AUCs approaching 0.5. Conclusion The CPS remains a robust predictor for ascites, and the MELD scores, particularly when sodium is included, are better for predicting hepatorenal syndrome and HCC. The limited utility of these scores for predicting varices and hepatic hydrothorax underscores the necessity for developing more sophisticated models or utilizing additional clinical parameters in prognostication.https://doi.org/10.1186/s43162-025-00478-xChild–Pugh scoreMELD scoreMELD-Na scoreLiver cirrhosisDecompensated liver diseaseDCLD
spellingShingle Anagha Ravinath Naik
Swathy Moorthy
A comparative analysis between Model for End-stage Liver Disease score (MELD), Modified Model for End-stage Liver Disease score (MELD-Na), and Child–Pugh score (CPS) in predicting complications among cirrhosis patients
The Egyptian Journal of Internal Medicine
Child–Pugh score
MELD score
MELD-Na score
Liver cirrhosis
Decompensated liver disease
DCLD
title A comparative analysis between Model for End-stage Liver Disease score (MELD), Modified Model for End-stage Liver Disease score (MELD-Na), and Child–Pugh score (CPS) in predicting complications among cirrhosis patients
title_full A comparative analysis between Model for End-stage Liver Disease score (MELD), Modified Model for End-stage Liver Disease score (MELD-Na), and Child–Pugh score (CPS) in predicting complications among cirrhosis patients
title_fullStr A comparative analysis between Model for End-stage Liver Disease score (MELD), Modified Model for End-stage Liver Disease score (MELD-Na), and Child–Pugh score (CPS) in predicting complications among cirrhosis patients
title_full_unstemmed A comparative analysis between Model for End-stage Liver Disease score (MELD), Modified Model for End-stage Liver Disease score (MELD-Na), and Child–Pugh score (CPS) in predicting complications among cirrhosis patients
title_short A comparative analysis between Model for End-stage Liver Disease score (MELD), Modified Model for End-stage Liver Disease score (MELD-Na), and Child–Pugh score (CPS) in predicting complications among cirrhosis patients
title_sort comparative analysis between model for end stage liver disease score meld modified model for end stage liver disease score meld na and child pugh score cps in predicting complications among cirrhosis patients
topic Child–Pugh score
MELD score
MELD-Na score
Liver cirrhosis
Decompensated liver disease
DCLD
url https://doi.org/10.1186/s43162-025-00478-x
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