Rapid Communication
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jan 14, 2008; 14(2): 286-291
Published online Jan 14, 2008. doi: 10.3748/wjg.14.286
Child-Pugh-Turcott versus Meld score for predicting survival in a retrospective cohort of black African cirrhotic patients
KA Attia, KC Ackoundou-N’guessan, AT N’dri-yoman, AK Mahassadi, E Messou, YF Bathaix, YH Kissi
KA Attia, AT N’dri-yoman, AK Mahassadi, YF Bathaix, YH Kissi, Service of Hepatology, Gastroenterology, and General medicine, Yopougon Teaching Hospital, Abidjan, Ivory Coast
KC Ackoundou-N’guessan, Service of Nephrology, Dialysis and Hypertension, Yopougon Teaching Hospital, Abidjan, Ivory Coast
E Messou, Centre for the Management, Research and Training on HIV/AIDS infection and related diseases (CEPREF-ACONDA VS), Yopougon-Attié, Abidjan, Ivory Coast
Correspondence to: Koffi Alain Attia, Service of General Medicine, Hepatology and Gastroenterology, University Hospital of Yopougon, PO BOX 632 Abidjan 21, Abidjan, Ivory Coast. attia_alain@hotmail.com
Telephone: +225-23-537550-142
Fax: + 225-22-482222
Received: July 21, 2007
Revised: September 24, 2007
Published online: January 14, 2008

AIM: To compare the performance of the Child-Pugh-Turcott (CPT) score to that of the model for end-stage liver disease (MELD) score in predicting survival of a retrospective cohort of 172 Black African patients with cirrhosis on a short and mid-term basis.

METHODS: Univariate and multivariate (Cox model) analyses were used to identify factors related to mortality. Relationship between the two scores was appreciated by calculating the correlation coefficient. The Kaplan Meier method and the log rank test were used to elaborate and compare survival respectively. The Areas Under the Curves were used to compare the performance between scores at 3, 6 and 12 mo.

RESULTS: The study population comprised 172 patients, of which 68.9% were male. The mean age of the patient was 47.5 ± 13 years. Hepatitis B virus infection was the cause of cirrhosis in 70% of the cases. The overall mortality was 31.4% over 11 years of follow up. Independent factors significantly associated with mortality were: CPT score (HR = 3.3, 95% CI [1.7-6.2]) (P < 0.001) (stage C vs stage A-B); Serum creatine (HR = 2.5, 95% CI [1.4-4.3]) (P = 0.001) (Serum creatine > 1.5 mg/dL versus serum creatine < 1.5 mg/dL); MELD score (HR = 2.9, 95% CI [1.63-5.21]) (P < 0.001) (MELD > 21 vs MELD < 21). The area under the curves (AUC) that predict survival was 0.72 and 0.75 at 3 mo (P = 0.68), 0.64 and 0.62 at 6 mo (P = 0.67), 0.69 and 0.64 at 12 mo (P = 0.38) respectively for the CPT score and the MELD score.

CONCLUSION: The CPT score displays the same prognostic significance as does the MELD score in black African patients with cirrhosis. Moreover, its handling appears less cumbersome in clinical practice as compared to the latter.

Keywords: Model for end-stage liver disease score, Child score, Cirrhosis, Black African, Survival