Child-Pugh Score Predicts Mortality Better than Model of End Stage Liver Disease: A Study in a Tertiary Care Hospital in the Periphery of Karachi

Abstract

Objective: To  observe the scores of the model of end-stage liver diseaseand Child-Pugh (CP) scores on hospital admission in patients of cirrhosis.

Methods: A cross-sectional study, in 6 months from September 17th  to March 18th, using non-probabil-      ity convenience sampling was conducted, in which we  inducted  165  patients  with  diagnosed  cirrhotic liver disease in aninpatient department.  We  noted  the  demographics  and  staged  the  patient  for  chronic liver disease according to Child-Turcotte-Pugh classification using ascites, encephalopathy, prothrombin time, serum albumin and serum bilirubin levels and compared it with MELD (Model for End-Stage Liver Disease) score  using  serum  bilirubin,  creatinine  and  change  in  INR.  We  predicted  the outcome of patient according to both scores.

Results: Out of 165 patients, 127 (76.96%, 84 males and 43 females) patients improved, while  38  (23.04%, 29 males and 9 females) patients expired. Correlation of CP and MELD scores was done by Pearson's bivariate correlation test and it gave  the  correlation  coefficient  of  0.626  with  highly  signifi- cant value of p<0.0001. The area under curve (AUC) was slightly more for CP (0.961) as compared to MELD (0.911).

Conclusion: The MELD score compared to the CP score does not appear to offer a clear advantage in predicting mortality in patients with  decompensated  cirrhosis,  but  comparatively  CP  score  per-  formed better than the MELD with significantly higher AUC.