Enhancement of Cirrhosis Mortality Prediction by Including Hepatic Encephalopathy to MELD 3.0 in a National Veteran Cohort
Despite negative outcomes, hepatic encephalopathy (HE) is not included in the Model for End-Stage Liver Disease (MELD) scores, including MELD 3.0. In a National Veterans Affairs database, we studied the additive mortality predictive impact of a documented inpatient overt HE diagnosis on MELD 3.0 and MELD-sodium (MELD-Na) scores in 75,327 veterans (26.8% with HE, 22% 90-day and 37% 1-year mortality). The addition of HE to MELD 3.0 and MELD-Na significantly improved their mortality prediction with interactions at 90 days and 1 year on multivariable regression. A documented inpatient HE episode is additive to the mortality prediction of MELD 3.0 by 4-5 extra points and could enhance future MELD iterations.
Authors
- Scott Silvey (ORCID: https://orcid.org/0000-0003-4540-4239)
- Jacqueline G O’Leary
- Jasmohan Singh Bajaj (ORCID: https://orcid.org/0000-0003-4928-3681)
- Nilang Patel (ORCID: https://orcid.org/0000-0003-0556-5820)
Institutions
- Hunter Holmes McGuire VA Medical Center (US)
- Dallas VA Medical Center (US)
- Virginia Commonwealth University Medical Center (US)
- The University of Texas Southwestern Medical Center (US)
Publication Details
- Journal
- The American Journal of Gastroenterology
- Published
- 2025-01-16
- DOI
- https://doi.org/10.14309/ajg.0000000000003317
- Citations
- 7
- Primary Topic
- Liver Disease Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 9.48
Funders
- U.S. Department of Veterans Affairs
- National Center for Advancing Translational Sciences