Scoring systems for prediction of mortality in decompensated liver cirrhosis: A meta-analysis of test accuracy

Table 1 The characteristics of studies included in the meta-analysis

Study	Country	Study design	Sex (M/F)	Age (yr)	Number of patients	End-point of observation	Scoring system	Etiology
Radisavljevic et al[20], 2017	Peru	p	79/8	54	87	29 mo	CTP, MESO, MELD	Alcohol
Iino et al[21], 2017	Japan	r	39/8	60	47	1.5 mo	CTP, MELD	HBV, HCV, Alcohol, Others
Barosa et al[22], 2017	Portugal	r	Unknown	62	49	1, 3 mo	CTP, MELD, MELD-Na	Alcohol, HCV
Cheng et al[23], 2016	China	p	87/12	48	98	1, 3, 6, 12 mo	CTP, MELD, MELD-Na	HBV
Bal et al[24], 2016	India	r	177/41	50	218	1.6 mo	MELD-Na	Ethanol, Crypto/NAFLD,HCV
Silva et al[25], 2015	Brazil	p	140/52	54	192	1 mo	MELD, CTP	Alcohol, HBV, HCV, Cryptogenic, Others
					189	3 mo	MELD, CTP
Fayad et al[26], 2015	Brazil	p	94/29	54	123	In hospital	MELD, MELD-Na, MESO	HBV, HCV, Alcohol, Cryptogenic, Others
Suk et al[27], 2012	Korea	p	46/11	48	57	36 mo	MELD, MELD-Na	Alcohol, Viral, Alcohol + Viral
Li et al[28], 2012	China	r	133/79	56	212	3, 6, 12 mo	MELD, MELD-Na, MESO	HBV, HCV, Alcohol, Primary biliary cirrhosis, Other
Shaikh et al[29], 2010	India	p	72/38	47	110	In hospital	MELD, CTP	HBV, HCV
Boursier et al[30], 2009	France	p	93/61	59	154	6 mo	CTP, MELD, MELD-Na	Alcohol, Viral, Others
Hyun et al[31], 2012	Korea	r	63/23	54	83	6 mo	CTP	HBV
Peng et al[32], 2015	China	r	94/51	57	145	In hospital	MELD, CTP	HBV, HCV, Alcohol, Unknown, Others
Sempere et al[33], 2009	Spain	r	142/59	59	201	1.5, 3, 12, 36 mo	MELD, CTP	Alcohol, Viral, Others
Teng et al[34], 2014	China	r	110/22	51	132	1.5 mo	MELD, CTP	Alcohol, HBV, HCV,
Wang et al[35], 2014	China	p	340/89	49	429	3, 12 mo	CTP, MELD-, MELA-Na	HCV, HBV, Alcohol, Biliary, Others

P: Prospectively study; r: Retrospectively study; CTP: Child-Turcotte-Pugh; MELD: Model for End-stage Liver Disease score; MESO: MELD to Serum Sodium ratio; HBV: Hepatitis B virus; HCV: Hepatitis C virus; NAFLD: Nonalcoholic fatty liver disease.

Table 2 Results of subgroup analysis of Child-Turcotte-Pugh, Model for End-stage Liver Disease score, and Model for End-stage Liver Disease-Na score in predicting mortality at different time points

End-point (mortality)	Number of studies	Sensitivity (95%CI)	Specificity (95%CI)	Positive (95%CI)	Negative (95%CI)	DOR (95%CI)	I2	AUROC
CTP
< 3 mo	8	0.72 (0.61, 0.81)	0.73 (0.65, 0.79)	2.6 (1.9, 3.7)	0.39 (0.26, 0.58)	7 (3, 14)	0	0.78
3 mo	5	0.79 (0.60, 0.91)	0.79 (0.59, 0.90)	3.7 (1.8, 7.6)	0.26 (0.13, 0.55)	14 (4, 46)	96	0.86
6 mo	3	0.90 (0.80, 0.96)	0.69 (0.64, 0.75)	3.0 (2.1, 4.5)	0.16 (0.08, 0.33)	18 (8, 40)	0	0.91
12 mo	3	0.68 (0.58, 0.72)	0.68 (0.64, 0.72)	3.3 (1.5, 7.3)	0.49 (0.40, 0.60)	7 (3, 20)	84	0.72
MELD
< 3 mo	9	0.66 (0.59, 0.73)	0.87 (0.81, 0.91)	5.1 (3.4, 7.7)	0.39 (0.31, 0.48)	13 (7, 24)	6	0.76
3 mo	6	0.70 (0.60, 0.78)	0.78 (0.65, 0.87)	3.1 (2.0, 4.9)	0.39 (0.29, 0.52)	8 (4, 15)	95	0.78
6 mo	3	0.74 (0.65, 0.82)	0.83 (0.79, 0.87)	4.4 (2.4, 8.2)	0.30 (0.23, 0.43)	15 (7, 34)	56	0.83
12 mo	4	0.60 (0.51, 0.68)	0.88 (0.79, 0.93)	4.8 (3.0, 7.7)	0.46 (0.39, 0.55)	10 (6, 17)	92	0.75
MELD-Na
< 3 mo	4	0.82 (0.69, 0.91)	0.82 (0.64, 0.92)	4.6 (2.2, 9.8)	0.21 (0.12, 0.37)	22 (9, 53)	89	0.89
3 mo	4	0.75 (0.63, 0.84)	0.84 (0.80, 0.87)	4.6 (3.5, 6.0)	0.30 (0.20, 0.46)	15 (8, 30)	0	0.86
6 mo	3	0.82 (0.73, 0.88)	0.85 (0.80, 0.88)	5.3 (3.7, 7.7)	0.22 (0.15, 0.32)	25 (14, 43)	0	0.90
12 mo	3	0.72 (0.63, 0.76)	0.83 (0.80, 0.86)	4.2 (3.4, 5.1)	0.37 (0.30, 0.45)	12 (8, 18)	0	0.84

CTP: Child-Turcotte-Pugh; MELD: Model for End-stage Liver Disease score; DOR: Diagnostic odd ratio; AUROC: Area under the summary receiver operating characteristic curve.

Table 3 Results of Child-Turcotte-Pugh and Model for End-stage Liver Disease score for predicting mortality in variceal hemorrhage patients within 3 mo

Subgroup	Number of study	Sensitivity (95%CI)	Specificity (95%CI)	Positive (95%CI)	Negative (95%CI)	DOR (95%CI)	I2	AUROC
CTP
Variceal hemorrhage	4	0.70 (0.58, 0.80)	0.71 (0.62, 0.78)	2.4 (1.8, 3.1)	0.42 (0.30, 0.60)	6 (3, 10)	19	0.76
Others	4	0.78 (0.46, 0.94)	0.74 (0.61, 0.84)	3.1 (1.5, 6.3)	0.30 (0.09, 1.02)	10 (1, 72)	0	0.81
MELD
Variceal hemorrhage	4	0.66 (0.53, 0.77)	0.87 (0.84, 0.90)	5.2 (3.9, 7.1)	0.39 (0.27, 0.56)	13 (7, 24)	0	0.88
Others	5	0.68 (0.57, 0.77)	0.87 (0.75, 0.93)	5.1 (2.4, 10.7)	0.37 (0.25, 0.54)	14 (5, 40)	0	0.79

CTP: Child-Turcotte-Pugh; MELD: Model for End-stage Liver Disease score; DOR: Diagnostic odd ratio; AUROC: Area under summarized receiver operating characteristic.