Prem Kumar Maheshwari, Ehsan Rahim Memon, Shabana Lakho, Zeeshan-ul Haque.
Model for end stage liver disease score & ALT-LDH index as poor prognostic indicators in acute liver failure.
Pak J Med Health Sci Jan ;13(4):985-8.

Aim : To determine the model for end stage liver disease (MELD) score and ALT-LDH index as poor prognostic markers among patients presented with acute liver failure Study Design : Case series study . Setting and duration : Department of gastroenterology Isra University Hospital from February 2015 to January 2016. Methods : All the patients presenting with acute liver failure were enrollment in the study. These patients were assessed for the grade of hepatic encephalopathy. ALT LDH index of <3.0 and MELD score of ≥30 were considered as poor prognostic markers . Patients were followed up to fifteen days and then the grade of encephalopathy was re-assessed. The primary end point was death within 15 days of admission to Hospital. All the data was recorded in the proforma. Results : Overall 151 cases were selected to study. Males were 59.6% and females were 40.4%, their mean-age was 22.58 years. 75.5% patients died during the study time. In 107 cases the MELD criteria cut off point was reached (MELD Score >30) and out of these 103 were died, therefore the accurately projected incidence of death for MELD score was 96.26 %. ALT-LDH index cut -off -point was reached in 55 cases and out of these 43 were died, thus correctly projected incidence of death for KCH criteria remained 78.18% . Non survival rate was significantly higher among males and 20 -30 years of age group, p-values were quite significant. Conclusion : Both the ALT LDH index and MELD score criteria are the best poor prognostic markers in acute hepatic failure . MELD -score was more significant in mortality prediction.

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