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首页> 外文期刊>Pakistan journal of medical sciences. >Comparison of King?s College Hospital Criteria (KCH) with Model for End-Stage Liver Disease (MELD) for Predicting Outcome in Patients with Acute Liver Failure
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Comparison of King?s College Hospital Criteria (KCH) with Model for End-Stage Liver Disease (MELD) for Predicting Outcome in Patients with Acute Liver Failure

机译：国王大学医院标准（KCH）与末期肝病模型（MELD）预测急性肝衰竭患者预后的比较

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Objective: To compare the Model for End-Stage Liver Disease (MELD) and The King?s College Hospital Criteria (KCH) as early clinical prognostic indicators in patients with Acute Liver Failure. Methodology: This descriptive Case series study was conducted in emergency medical wards of Liaquat University Hospital Jamshoro and Hyderabad from February 2008 to July 2010. This study included 76 consecutive patients with ALF defined as onset of hepatic encephalopathy occurring within 12 weeks of onset of jaundice. The patients using sedatives, anticoagulants or if any evidence of chronic liver disease were excluded. Laboratory workup was done from laboratory of University. MELD score of ? 33 and presence of positive criteria for KCH category were taken as a bad prognostic indicator. The primary end point was death during hospital stay. Continuous variables were computed as mean ? standard deviation (SD) and categorical variables as frequency and percentage. Results: Out of 76 patients 49 were male (64.47%) and 27 (35.53%) female. The mean age of patients was 24.62 ? 10.3. Out of 76 patients a total of 59 patients (77.63%) died during the study period. The KCH criteria cut off point was reached in a total of 63 patients (out of 76) of which 50 patients died. The MELD criteria cut off point (MELD Score > 33) was reached in 49 patients (out of 76) of which 46 eventually died.KCH predicted outcome with the sensitivity of 80% and Positive predictive value (PPV) of 89% (p=0.001). MELD predicted outcome with sensitivity of 82.4% and Positive predictive value (PPV) of 94%(p=0.001).Viral hepatitis B was the most common cause of Acute Liver Failure. Conclusion: Both criteria are good predictors of the outcome in acute liver failure.
机译：目的：比较终末期肝病模型（MELD）和金斯学院医院标准（KCH）作为急性肝衰竭患者早期临床预后指标。方法：该描述性病例系列研究于2008年2月至2010年7月在Liaquat大学医院Jamshoro和Hyderabad的急诊室进行。该研究包括76例连续的ALF患者，定义为在黄疸发作后12周内发生肝性脑病。排除使用镇静剂，抗凝剂或任何慢性肝病迹象的患者。实验室检查是由大学实验室完成的。 MELD得分为？ 33且KCH类别阳性标准的存在被认为是不良的预后指标。主要终点是住院期间的死亡。连续变量计算为均值？标准差（SD）和分类变量（如频率和百分比）。结果：在76例患者中，男性49例（64.47％），女性27例（35.53％）。患者的平均年龄为24.62？ 10.3。在研究期间，在76位患者中，共有59位患者（77.63％）死亡。共有63例患者（其中76例）达到了KCH标准的临界点，其中50例患者死亡。在49名患者中（76名患者）达到了MELD临界点（MELD得分> 33），其中46名最终死亡.KCH预测结局，敏感性为80％，阳性预测值（PPV）为89％（p = 0.001）。 MELD预测结果的敏感性为82.4％，阳性预测值（PPV）为94％（p = 0.001）。乙型肝炎是急性肝衰竭的最常见原因。结论：这两个标准都是急性肝衰竭结果的良好预测指标。

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