A model to predict survival in patients with end-stage liver disease

doi:10.1016/S0016-5085(08)80377-0

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A model to predict survival in patients with end-stage liver disease

Journal Article•DOI•

A model to predict survival in patients with end-stage liver disease

Patrick S. Kamath, Russell H. Wiesner, Michael Malinchoc, Walter K. Kremers, Terry M. Therneau, Gennaro D'Amico, Catherine L. Kosberg, E. R. Dickson, W. R. Kim - Show less +5 more

01 Apr 2001-Gastroenterology (Elsevier)-Vol. 120, Iss: 5

TL;DR: The MELD scale is a reliable measure of mortality risk in patients with end-stage liver disease and suitable for use as a disease severity index to determine organ allocation priorities in patient groups with a broader range of disease severity and etiology.

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About: This article is published in Gastroenterology.The article was published on 2001-04-01. It has received 1452 citations till now.

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AASLD PRACTICE GUIDELINE Management of Hepatocellular Carcinoma: An Update

[...]

Jordi Bruix, Morris Sherman

01 Jan 2010

TL;DR: Since the publication of the American Association for the Study of Liver Diseases (AASLD) practice guidelines on the management of hepatocellular carcinoma (HCC) in 2005, new information has emerged that requires that the guidelines be updated.

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Abstract: Since the publication of the American Association for the Study of Liver Diseases (AASLD) practice guidelines on the management of hepatocellular carcinoma (HCC) in 2005, new information has emerged that requires that the guidelines be updated. The full version of the new guidelines is available on the AASLD Web site at http://www.aasld.org/practiceguidelines/ Documents/Bookmarked%20Practice%20Guidelines/ HCCUpdate2010.pdf. Here, we briefly describe only new or changed recommendations.

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6,642 citations

Journal Article•DOI•

Management of hepatocellular carcinoma.

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Jordi Bruix¹, Morris Sherman²•Institutions (2)

University of Barcelona¹, University Health Network²

01 Nov 2005-Hepatology

TL;DR: The prevention of Cirrhosis can prevent the development of HCC and progression from chronic HCV infection to advanced fibrosis or cirrhosis may be prevented in 40% of patients who are sustained responders to new antiviral strategies, such as pegylated interferon and ribavirin.

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5,557 citations

Journal Article•DOI•

Acetaminophen-induced acute liver failure: results of a United States multicenter, prospective study.

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Anne M. Larson¹, Julie Polson², Robert J. Fontana³, Timothy J. Davern⁴, Ezmina Lalani², Linda S. Hynan², Joan S. Reisch², Frank V. Schiødt², George Ostapowicz², A. Obaid Shakil⁵, William M. Lee² - Show less +7 more•Institutions (5)

University of Washington Medical Center¹, University of Texas Southwestern Medical Center², University of Michigan³, University of California, San Francisco⁴, University of Pittsburgh⁵

01 Dec 2005-Hepatology

TL;DR: In conclusion, acetaminophen hepatotoxicity far exceeds other causes of acute liver failure in the United States, and education of patients, physicians, and pharmacies to limit high‐risk use settings is recommended.

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1,705 citations

Additional excerpts

...0001 MELD score (n 268) 36 (11-53) 28 (7-52) <....
[...]
...Age (years) 38 (18-76) 131 34 (17-68) 122 Sex (% female) 96 (73%) 131 90 (74%) 122 Survival without transplantation 84 (64%) 131 80 (66%) 122 Liver transplantation 12 (9%) 131 8 (7%) 122 Listed for liver transplantation 35 (27%) 130 30 (25%) 122 Days from admission to transplantation 3 (1-7) 11 3 (2-5) 7 Overall short-term (3-week) survival 94 (72%) 131 87 (71%) 122 NAC treatment given 125 (95%) 131 106 (87%) 122 Cause of pain reported* 107 (81%) 116 0 (0%) 122 Total acetaminophen dose (g) 20 (2....
[...]
...Age (yrs) 37 (17-76) Sex, n (% female) 204 (74%) Race White 242 (88%) African American 15 (5%) Asian 6 (2%) Hispanic 5 (2%) Native American 3 (1%) Other 4 (2%) Overdose Type Unintentional 131 (48%) Intentional 122 (44%) Unknown 22 (8%) Serum acetaminophen level, g/dL (n 257) 31 (0-644) Acetaminophen dose, g (n 179) 24 (1....
[...]
...2-90) 91 Serum acetaminophen ( g/dL) 18 (0-400) 119 64 (0-644) 118 Narcotic/acetaminophen use 83 (63%) 131 22 (18%) 122 Antidepressant use 48 (37%) 131 46 (38%) 122 Serum ALT (U/L) 3,319 (126-18,079) 130 5,326 (179-19,826) 122 Platelets (thousands/ L) 126 (15-699) 131 120 (5-447) 120 Admission Hepatic Coma stage 3 (1-4) 131 2 (1-4) 118 Admission Hepatic Coma (stages 3-4) 72 (55%) 131 47 (39%) 122 Peak hepatic coma stage 3 (1-4) 131 3 (1-4) 120 Peak hepatic coma (stages 3-4) 89 (68%) 131 72 (59%) 122 Met King’s criteria 26 (20%) 131 8 (7%) 122 Creatinine 2 74 (57%) 131 53 (43%) 122 INR 3 56 (42%) 131 68 (56%) 122 ALT 3,500 63 (48%) 131 88 (72%) 122 Bilirubin 4 73 (56%) 131 74 (61%) 122 MELD 20 113 (88%) 129 102 (87%) 117 APACHE II 15 75 (66%) 113 49 (57%) 86 BMI 25 (17-51) 97 24 (16-56) 99...
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Journal Article•DOI•

Characteristics associated with liver graft failure: the concept of a donor risk index.

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Sandy Feng¹, Nathan P. Goodrich, Jennifer L. Bragg-Gresham, Dawn M. Dykstra, J. D. Punch², M. A. DebRoy³, S. M. Greenstein⁴, Robert M. Merion² - Show less +4 more•Institutions (4)

University of California, San Francisco¹, University of Michigan², University of Medicine and Dentistry of New Jersey³, Yeshiva University⁴

01 Apr 2006-American Journal of Transplantation

TL;DR: A quantitative donor risk index was developed using national data from 1998 to 2002 to assess the risk of donor liver graft failure using seven donor characteristics that independently predicted significantly increased risk of graft failure.

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1,657 citations

Journal Article•DOI•

Liver enzyme alteration: a guide for clinicians

[...]

Edoardo G. Giannini¹, Roberto Testa, Vincenzo Savarino•Institutions (1)

University of Genoa¹

01 Feb 2005-Canadian Medical Association Journal

TL;DR: In this review, a schematic approach is used that classifies enzyme alterations as predominantly hepatocellular or predominantly cholestatic, and abnormal enzymatic activity within the 2 subgroups are reviewed.

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Abstract: ISOLATED ALTERATIONS OF BIOCHEMICAL MARKERS OF LIVER DAMAGE in a seemingly healthy patient can present a challenge for the clinician. In this review we provide a guide to interpreting alterations to liver enzyme levels. The functional anatomy of the liver and pathophysiology of liver enzyme alteration are briefly reviewed. Using a schematic approach that classifies enzyme alterations as predominantly hepatocellular or predominantly cholestatic, we review abnormal enzymatic activity within the 2 subgroups, the most common causes of enzyme alteration and suggested initial investigations.

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1,488 citations

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References

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Journal Article•DOI•

The meaning and use of the area under a receiver operating characteristic (ROC) curve.

[...]

James A. Hanley, Barbara J. McNeil

01 Apr 1982-Radiology

TL;DR: A representation and interpretation of the area under a receiver operating characteristic (ROC) curve obtained by the "rating" method, or by mathematical predictions based on patient characteristics, is presented and it is shown that in such a setting the area represents the probability that a randomly chosen diseased subject is (correctly) rated or ranked with greater suspicion than a random chosen non-diseased subject.

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Abstract: A representation and interpretation of the area under a receiver operating characteristic (ROC) curve obtained by the "rating" method, or by mathematical predictions based on patient characteristics, is presented. It is shown that in such a setting the area represents the probability that a randomly chosen diseased subject is (correctly) rated or ranked with greater suspicion than a randomly chosen non-diseased subject. Moreover, this probability of a correct ranking is the same quantity that is estimated by the already well-studied nonparametric Wilcoxon statistic. These two relationships are exploited to (a) provide rapid closed-form expressions for the approximate magnitude of the sampling variability, i.e., standard error that one uses to accompany the area under a smoothed ROC curve, (b) guide in determining the size of the sample required to provide a sufficiently reliable estimate of this area, and (c) determine how large sample sizes should be to ensure that one can statistically detect difference...

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19,398 citations

Journal Article•DOI•

Prediction of Creatinine Clearance from Serum Creatinine

[...]

Donald W. Cockcroft, M H Gault

01 Jan 1976-Nephron

TL;DR: A formula has been developed to predict Creatinine clearance from serum creatinine (Scr) in adult males: Ccr = (140 – age) (wt kg)/72 × Scr (mg/100ml) (15% less i).

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Abstract: A formula has been developed to predict creatinine clearance (Ccr) from serum creatinine (Scr) in adult males: Ccr = (140 – age) (wt kg)/72 × Scr(mg/100ml) (15% less i

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14,211 citations

Journal Article•DOI•

Transection of the oesophagus for bleeding oesophageal varices

[...]

R. N. H. Pugh¹, I. M. Murray-Lyon¹, J. L. Dawson¹, M. C. Pietroni¹, Roger Williams¹ - Show less +1 more•Institutions (1)

University of Cambridge¹

07 Dec 2005-British Journal of Surgery

TL;DR: Emergency ligation of bleeding oesophageal varices using the Milnes Walker technique was performed in 38 patients, and in patients with good preoperative liver function this rose to 71% and the simple scoring system for grading the severity of disturbance of liver function was found to be of value in predicting the outcome of surgery.

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Abstract: Emergency ligation of bleeding oesophageal varices using the Milnes Walker technique was performed in 38 patients. Haemorrhage continued or recurred in hospital in 11 patients, all of whom subsequently died. A further 10 patients died in hospital following operation from hepatic failure and a variety of other causes. Five patients were finally considered suitable for elective shunt surgery, but of 12 patients who were discharged without a further operation, only 2 have re-bled. Although the overall 6-month survival was 32 per cent, in patients with good preoperative liver function this rose to 71 per cent, and the simple scoring system for grading the severity of disturbance of liver function was found to be of value in predicting the outcome of surgery. Since the results of emergency ligation of bleeding oesophageal varices in our hands have been so disappointing we are currently using it less and are trying the mesenteric caval jump graft as an emergency operation for the control of bleeding varices.

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7,262 citations

Journal Article•DOI•

A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts.

[...]

Michael Malinchoc¹, Patrick S. Kamath¹, Fredric D. Gordon², Craig J. Peine³, Jeffrey M. Rank⁴, Pieter C.J. ter Borg - Show less +2 more•Institutions (4)

Mayo Clinic¹, Beth Israel Deaconess Medical Center², Hennepin County Medical Center³, University of Minnesota⁴

01 Apr 2000-Hepatology

TL;DR: This Mayo TIPS model may predict early death following elective TIPS for either prevention of variceal rebleeding or for treatment of refractory ascites, superior to both the Child‐Pugh classification and the Child-Pugh score in predicting survival.

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2,479 citations