4, 9 Transition from a compensated to a decompensated stage occurs at a rate of 5-7% per year. Decompensated cirrhosis is defined by the presence of ascites, variceal bleeding, encephalopathy and/or jaundice. This classification is simple and reproducible and identifies patients at a similar rate of disease progression and survival. This review article will highlight current status about the prognostic scores in end-stage liver disease focusing on the Child-Pugh score and MELD score.ĬLASSIFICATION OF END-STAGE LIVER DISEASE AND PROGNOSISĬirrhosis is classified into two stages compensated and decompensated. 8 Therefore, whether Child-Pugh score should be definitely abandoned for MELD score remains uncertain. 7 In recent large systematic review, the Child-Pugh score and MELD score were found to be predictive of death. Therefore, the MELD has replaced the Child-Pugh score for prioritizing liver donor allocation. The longevity of the Child-Pugh score can be explained by its empirical simplicity, its intuitiveness, and, overall, its good accuracy across a broad spectrum of causes and specific situations.Īmong additional prognostic scores proposed, 3- 6 the model for end-stage liver disease (MELD) is more reproducible than the Child-Pugh score because it does not include subjective variables such as ascites and encephalopathy. Many prognostic models and scores have been proposed in the last two decades to predict prognosis in patients with end-stage liver disease and to determine the most appropriate therapeutic option.Ĭhild score 1 and modified Child-Pugh score 2 thereafter, has been the reference for assessing the prognosis of cirrhosis for about three decades in end-stage liver disease.

Therefore, predicting the prognosis has been the important issue for allocating the liver transplantation, the only definite treatment for these patients. With the rapid progress of medical science, liver transplantation significantly improves the survival and quality of life of patients with end-stage liver disease. Therefore, establishing a prognosis in a given patient with cirrhosis remains a challenging issue. The course of cirrhosis is extremely variable from patient to patient due to several factors, including hepatic synthetic function (or 'hepatic reserve'), the cause of cirrhosis, and the occurrence of liver malignancy. The high mortality of end-stage liver disease is a global public health problem. This review summarizes the current knowledge about the prognostic factors in end-stage liver disease, focusing on the role of Child-Pugh and MELD score. Due to several weakness of MELD score, new modified MELD scores (MELD-Na, Delta MELD) have been developed and validated. The MELD score has been an important role to accurately predict the severity of liver disease and effectively assess the risk of mortality. Recently, Model for end-stage liver disease (MELD) score emerged as a 'modern' alternative to Child-Pugh score. Despite of several limitations, recent large systematic review showed that Child-Pugh score was still robust predictors and it's components (bilirubin, albumin and prothrombin time) were followed by Child-Pugh score. Child-Pugh score has been the reference for assessing the prognosis of cirrhosis for about three decades in end-stage liver disease. For predicting prognosis of end-stage liver disease, many prognostic models were proposed. Prognosis is an essential part of the baseline assessment of any disease.

Meld score 8 life expectancy