Article Text

Download PDFPDF
MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study
  1. F Botta1,*,
  2. E Giannini1,*,
  3. P Romagnoli1,
  4. A Fasoli1,
  5. F Malfatti1,
  6. B Chiarbonello1,
  7. E Testa1,
  8. D Risso2,
  9. G Colla3,
  10. R Testa1
  1. 1Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Italy
  2. 2Department of Health Science, University of Genoa, Genoa, Italy
  3. 3Department of Laboratory Medicine, S Martino Hospital, Genoa, Italy
  1. Correspondence to:
    Professor R Testa, Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Viale Benedetto XV, No 6, 16132 Genoa, Italy;


Background: Indices for predicting survival are essential for assessing prognosis and assigning priority for liver transplantation in patients with liver cirrhosis. The model for end stage liver disease (MELD) has been proposed as a tool to predict mortality risk in cirrhotic patients. However, this model has not been validated beyond its original setting.

Aim: To evaluate the short and medium term survival prognosis of a European series of cirrhotic patients by means of MELD compared with the Child-Pugh score. We also assessed correlations between the MELD scoring system and the degree of impairment of liver function, as evaluated by the monoethylglycinexylidide (MEGX) test.

Patients and methods: We retrospectively evaluated survival of a cohort of 129 cirrhotic patients with a follow up period of at least one year. The Child-Pugh score was calculated and the MELD score was computed according to the original formula for each patient. All patients had undergone a MEGX test. Multivariate analysis was performed on all variables to identify the parameters independently associated with one year and six month survival. MELD values were correlated with both Child-Pugh scores and MEGX test results.

Results: Thirty one patients died within the first year of follow up. Child-Pugh and MELD scores, and MEGX serum levels were significantly different among patients who survived and those who died. Serum creatinine, international normalised ratio, and MEGX60 were independently associated with six month mortality while the same variables and the presence of ascites were associated with one year mortality. MELD scores showed significant correlations with both MEGX values and Child-Pugh scores.

Conclusions: In a European series of cirrhotic patients the MELD score is an excellent predictor of both short and medium term survival, and performs at least as well as the Child-Pugh score. An increase in MELD score is associated with a decrease in residual liver function.

  • cirrhosis
  • liver function
  • ascites
  • creatinine
  • Child-Pugh score
  • MELD
  • MEGX
  • OLT, orthotopic liver transplantation
  • MEGX, monoethylglycinexylidide
  • MELD, model for end stage liver disease
  • TIPSS, transjugular intrahepatic portosystemic stent shunt
  • INR, international normalised ratio
  • HCV, hepatitis C virus
  • HBV, hepatitis B virus
  • HDV, hepatitis D virus
  • ROC, receiver operating characteristic
  • SS, sensitivity
  • SP, specificity
  • RR, relative risk

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • * F Botta and E Giannini contributed equally to this work.