Comparison of MELD and Child-Pugh Score for the Prediction of Survival in Portal Hypertension Undergoing Transjugular Intrahepatic Portosystemic Shunt

Objectives: Recently, the model for End-Stage Liver Disease (MELD) was proposed for the prediction of survival in transjugular intrahepatic portosystemic shunt (TIPS) patients. We therefore compared the prognostic accuracy of the MELD model and the Child-Pugh score, in an unselected cohort of TIPS patients followed long-term. Methods: A retrospective chart review and statistical analyses were done on 120 patients consecutively admitted for portal hypertension from 2009 to 2013 in the Jinling hospital (Nanjing, China). Results: The survival rate for all patients was 95.8% at 3 months, 90% at 1 year, and 85.8% at 3 years. Signifi cantly lower survival rates were found in patients with MELD scores of 15 or more in comparison to those with MELD scores of 15 or less (p<0.001).There was no signifi cant difference in survival rate between patients with Child-Pugh classifi cation A and those with Child-Pugh classifi cation B, while the patients with Child-Pugh classifi cation C has a signifi cantly lower survival rate than those with Child-Pugh classifi cation A and B (p<0.001). The discrimination powers of MELD (c statistics: 0.772, 0.680, 0.647 for 3-month, 1-year, and 3-year survival) were not signifi cantly different from the discrimination powers of Child-Pugh score at the same time points (c statistics: 0.795, 0.732, 0.678). Conclusions: The Child-Pugh classifi cation is only slightly superior to the MELD score for the prediction of long-term survival in TIPS patients. Therefore, the search continues for an entirely new scoring system to further improve prognostic accuracy. Case Report Comparison of MELD and ChildPugh Score for the Prediction of Survival in Portal Hypertension Undergoing Transjugular Intrahepatic Portosystemic Shunt Liu Kai1, Wang Shikai1, Wu Xingjiang2*, Fan Xinxin3, He Changsheng4 and Li Jieshou2 1M.D. General Surgery, Medical School of Nanjing University, China 2Chief Physician, Research Institute of General Surgery, Jinling Hospital, Clinical School of Medicine, Nanjing University, Nanjing 210002, Jiangsu Province, China 3A Resident Physician, Research Institute of General Surgery, Jinling Hospital, Clinical School of Medicine, Nanjing University, Nanjing 210002, Jiangsu Province, China 4An Attending Physician, Research Institute of General Surgery, Jinling Hospital, Clinical School of Medicine, Nanjing University, Nanjing 210002, Jiangsu Province, China Dates: Received: 06 January, 2017; Accepted: 20 March, 2017; Published: 22 March, 2017 *Corresponding author: Wu Xingjiang, Chief Physician of Research Institute of General Surgery, Jinling Hospital, Clinical School of Medicine, Nanjing University, Nanjing 210002, Jiangsu Province, China, E-Mail: