Waheedullah, Muhammad Daud, Muhammad Iltaf, Nizar Khan.
Validity of "Model for End Stage Liver Disease" (MELD-Na) Scores in Predicting 3 Months Mortality following Acute Variceal Bleeding in Patients having Cirrhosis due to Hepatitis causing Mortality after 3 months as a Gold Standard.
Ophthalmol Update Jan ;12(4):326-30.

Objective: To determine the frequency of high model for end stage liver disease score and its three months mortality among patients presenting with variceal bleeding due to liver cirrhosis with hepatitis C. In Pakistan limited work has been done on MELD and MELD-Na score. We therefore aim to apply MELD-Na scoring system as predictor of short term outcome in patients who are having end stage liver disease secondary to chronic hepatitis C and presenting with acute variceal haemorrhage. Study design: Descriptive case series. Duration: The duration of study was six months after approval of synopsis. Settings: Department of Gastroenterology and Hepatology Hayatabad Medical Complex Peshawar. Material & Methods: This study was conducted on 151 patients. All of them had end stage liver disease secondary to chronic hepatitis C and presented to the department of gastroenterology and hepatalogy with acute variceal hemorrhage Patients were admitted through emergency and outpatient department. MELD Na score was calculated at the time of arrival and these patients were contacted either by phone or advised followed up after 3 months. The outcome (survival or death) of each patient with chronic severe hepatitis C was recorded. The end point of observation was 3 months. The inclusion and exclusion criteria?s were strictly observed. This study was in accord with current ethical guidelines and hospital ethical committee. Results: This study was conducted in Department of Gastroenterology and hepatology Hayatabad Medical Complex, Peshawar. A total of 151 patients were included. All of them had end stage liver disease secondary to chronic Hepatitis C. Mean MELD - Na score in my study was 35±8. Of the 151 patients 92 (61%) were males and 59 (39%) were female. Out of 92 males, 69 (75%) died while out of 59 female 44 (64%) died within the study period. High MELD - Na Score was observed in 121 (80.1%) patients while 30 (19.9%) patients had low MELD - Na score. Out of 151 total patients 113 (74.8%) died within the study time period, most of the death occurred in those who has a MELD-Na score of 30 and above and who had age of 60±5 years. Conclusion: In conclusion, it has been proven that MELD Na Score, which is an accurate and objective measure of liver disease severity, is also a significant and strong predictor of short-term mortality after an AVH.

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