Background/Aims: Serum sodium predicts prognosis in cirrhosis and may improve the prognostic accuracy of MELD score, but the available information is limited. We aimed to assess the prognostic value of serum sodium in the prediction of survival at 3 and 12 months after listing in patients with cirrhosis awaiting liver transplantation and compare its predictive value with that of MELD score.
Patients and Methods: Three-hundred and eight consecutive patients with cirrhosis listed for transplantation during a 5-year period were included in the study. End-point was survival at 3 and 12 months before transplantation. Variables obtained at the time of listing were analyzed for prognostic value using multivariable analysis. Accuracy of prognostic variables was analyzed by ROC curves.
Results: MELD score and serum sodium concentration were the only independent predictors of survival at 3 and 12 months after listing. Low serum sodium was associated with an increased risk of death in all subpopulations of patients with cirrhosis categorized according to the major complication developed before listing. The area under the ROC curves for serum sodium and MELD score was not significantly different both at 3 months (0.83 vs. 0.79, respectively) and at 12 months (0.70 vs. 0.77, respectively). The addition of serum sodium did not improve significantly the accuracy of MELD score in the prediction of survival at 3 and 12 months.
Conclusion: In patients with cirrhosis awaiting liver transplantation, serum sodium and MELD were found to be independent predictors of survival. Larger studies are needed to determine whether the addition of serum sodium to MELD can improve its prognostic accuracy.
- liver transplantation
- MELD score
- serum sodium
- waiting list