Kazim Abbas Virk, Sana Tahir Virk, Inayat Adil, Shiza Tahir Virk, Haseeb Noor, Tehzeeb Zehra.
Child-Turcotte-Pugh and Model for End-stage Liver Disease Scores: Accuracy of Predictability for Mortality in Acute Variceal Hemorrhage.
Life Science Jan ;2(1):22-9.

To determine a score that best predicts the mortality of admitted patients within six weeks of Acute Variceal Hemorrhage (AVH). Study Design: Cross sectional study. Place and Duration of Study: The study was conducted at Inpatient Department of Gastroenterology Unit at th th Pakistan Institute of Medical Sciences (PIMS), Islamabad from 30 April 2017 to 30 October 2017. Materials and Methods: The number of patients with AVH enrolled in this study were 223. A pretested questionnaire was used to gather the required information; Model for End-stage Liver Disease (MELD) and Child-Turcotte-Pugh (CTP) scores of each patient were recorded at the time of admission in the inpatient facility. The outcome was documented via a telephonic call at the end of six weeks. The primary outcome of the study was "mortality" at end of six weeks. Results: The total number of participants were 223, including 61% (n=136) males and 39% (n=87) females. The mean age was 52.4?13.96. The overall mean value of CTP score was 9.6?2.8 and mean value of MELD score was 19.3?6.7, while the mean values of CTP and MELD among non-survivors were 12.9?2.1 and 26.6?5.6, respectively. After six weeks, the number of deaths were 27% (n=60). The MELD had positive predictive value (PPV) of 83.3%, negative predictive value (NPV) of 96.8%, sensitivity: 91.7%, specificity: 93.3%, diagnostic accuracy: 92.82%, and positive likelihood ratio of 13.68. Similarly, CTP had PPV: 77.4%, NPV: 92.5%, sensitivity: 80%, specificity: 91.4%, diagnostic accuracy: 88.34% and positive likelihood ratio of 9.3. The area under the curve (AUC)for MELD was 0.91, while CTP was 0.90. Conclusion: The MELD score is better in its discriminative ability and more accurate in predicting six weeks mortality in patients with AVH than CTP score.

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