Introduction

Currently, there are several prognostic scores developed to predict mortality in liver cirrhosis. Child-Pugh-Turcotte (CPT) and MELD-Na scores are the most used and validated in current practice. Recently, BAVENO consensus issued new recommendations for a better assessment of the rate of decompensation of liver cirrhosis as well as long- and short-term mortality rates. In this study, we aimed to evaluate the accuracy of both CPT and MELD-Na scores to predict BAVENO stages.

Aims & Methods

We conducted a retrospective study in which consecutive patients with liver cirrhosis admitted to the St. Spiridon Emergency Hospital Iasi between January 2023 and April 2024, were included. All cases were assigned to different prognostic stages according to BAVENO and MELD-Na and CPT scores were compared between the groups.

Results

Of the 155 patients included, 54.8% were males, with an average age of 57.81±12.36 years. According to BAVENO staging, 68% of patients were classified as a BAVENO stage 6, 10% as stage 5, 5% as stage 4, 10% as stage 3, 6% as stage 2, and 1% as stage 1. We found a positive correlation between MELD-Na Score and Child Pugh Score (r=0,774) with significant p-value (P<0.0001). Furthermore, our results demonstrate superior sensitivity and specificity for the MELD-Na score (98.7% and 97.9%, AUC-0.997) compared to the Child-Pugh score, which showed a sensitivity of 71.2% (AUC-0.792) to predict a stage 6 diagnosis and worst prognosis overall. At a cut-off of 34, MELD-Na score was the most accurate to discriminate between BAVENO stage 5 and 6, a cut off of 22 between BAVENO 4 and 5 and a cut off of 13 was the most accurate to discriminate between BAVENO stage 3 and stage 4.

Conclusion

Mortality rates and poor prognosis increase exponentially with liver cirrhosis decompensation, thus their assessment through predictive scores remains a highly desirable target for clinicians, MELD-Na score retaining its superiority in predicting the evolution through the BAVENO stages.