ENHANCEMENT OF CIRRHOSIS MORTALITY PREDICTION BY INCLUDING HEPATIC ENCEPHALOPATHY TO MELD3.0 IN A NATIONAL VETERAN COHORT

Scott Silvey; Nilang Patel; Jacqueline G O'Leary; Jasmohan S Bajaj

doi:10.14309/ajg.0000000000003317

ENHANCEMENT OF CIRRHOSIS MORTALITY PREDICTION BY INCLUDING HEPATIC ENCEPHALOPATHY TO MELD3.0 IN A NATIONAL VETERAN COHORT

Am J Gastroenterol. 2025 Jan 16. doi: 10.14309/ajg.0000000000003317. Online ahead of print.

Authors

Scott Silvey¹, Nilang Patel², Jacqueline G O'Leary³, Jasmohan S Bajaj²

Affiliations

¹ Department of Biostatistics, Virginia Commonwealth University and Richmond VA Medical Center, Richmond, Virginia.
² Department of Medicine, Virginia Commonwealth University and Richmond VA Medical Center, Richmond, Virginia.
³ Department of Medicine, University of Texas Southwestern and Dallas VA Medical Center, Dallas, Texas.

PMID: 39836914
DOI: 10.14309/ajg.0000000000003317

Abstract

Despite negative outcomes, hepatic encephalopathy (HE) is not included in model-for-end-stage liver disease (MELD) scores, including MELD3.0. In a national Veterans affairs (VA) database, we studied the additive mortality predictive impact of a documented inpatient overt HE diagnosis on MELD3.0 and MELD-Na scores in 75,327 Veterans (26.8% with HE, 22% 90-day and 37% 1-year mortality). The addition of HE to MELD3.0 and MELD-Na significantly improved their mortality prediction with interactions at 90-days and 1-year on multivariable regression. A documented inpatient HE episode is additive to the mortality prediction of MELD3.0 by 4-5 extra points and could enhance future MELD iterations.

Abstract

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