Clinical Trends for September 2015

Ryan Syrek

Disclosures

September 25, 2015

Clinical Trend of the Week (Sept 12-18): MELD Score

Promising research drove physician searches this week, as a new risk score has been proposed for determining patients with chronic hepatitis B virus (HBV) who are at high risk for developing acute-on-chronic liver failure (ACLF). The score incorporates four factors associated with ACLF risk: age of 40 years or older, bilirubin levels ≤171 µmol/L, prothrombin activity of 40% to 60%, and HBV DNA levels higher than 107 copies/mL. The model had a concordance index of 0.857 in patients assigned to the derivation cohort and 0.889 in those assigned to the validation cohort. By comparison, the Model for End-Stage Liver Disease (MELD) score, had an index of 0.601 and 0.632 in the derivation and validation cohorts, respectively. Although MELD and the Child-Turcotte-Pugh (CTP) scores remain the current standard, physicians are no doubt watching this promising new tool.

For more in-depth clinical information, see Liver Transplantation.

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