![]() ![]() It is expressed as “MESO index = (MELD Score/SNa mEq/L)*10”. Huo et al, based on the MELD, devised serum sodium ratio index (MESO) to enhance the precision of MELD’s predictions in compensated and decompensated patients. Biggins et al developed an evidence-based model, “MELD-Na,” which was calculated with the formula “MELD-NA = MELD + 1.59 (135-Na)”. Then, based on MELD, refined models were established for prediction of mortality in liver disease. In the following years, research emerged claiming that serum Na was a predictor of mortality in patients with cirrhosis and might improve the accuracy of MELD. Compared to CTP, MELD is more objective and clinically useful for defining disease severity. This scoring system added serum creatinine, total serum bilirubin, international normalized ratio for prothrombin time evaluation, and the etiology of cirrhosis as predicting factors. Thus, in 2001, MELD was established by UNOS for allocation. Due to the lack of statistical weighting and factors resulting from complications, such as renal and pulmonary dysfunction, CTP is limited in predicting the mortality of decompensated cirrhosis patients. The CTP is a “modified Child score” that was first proposed in 1964, and it has been widely used for several decades for the prognostication of patients with cirrhosis. Until now, various scoring systems have been used to predict the mortality of liver decompensated cirrhosis, including the Child–Turcotte–Pugh (CTP), Model for End-stage Liver Disease score (MELD), MELD-Na, MELD to Serum Sodium ratio (MESO) and so on. In addition, the mathematical model could be used as a tool to better allocate donated organs to recipients in need among the liver transplantation community. On one hand, accurate prognostic scoring systems could help clinicians make better diagnoses and select effective therapies with less time, thus improving the prognosis of patients. The poor survival of patients with decompensated cirrhosis has pushed doctors to explore more efficient treatment methods and to find more accurate prognostic scoring systems to recognize and manage the patients. Decompensated cirrhosis is associated with a risk of death that is 9.7 times higher than the risk in the general population. Its development includes an asymptomatic phase called “compensated” cirrhosis, followed by a progressive phase characterized by hypertension and/or liver dysfunction, including ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, variceal hemorrhage, hepatorenal syndrome, and hepatocellular carcinoma, which is called “decompensated” cirrhosis. Liver cirrhosis is a common chronic disease that is also the leading cause of deaths among nonmalignant diseases worldwide. ![]()
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