Effectiveness of the MELD/Na score and the Child-Pugh score for the identification of palliative care needs in patients with cirrhosis of the liver

Abstract

Objective: Identification of palliative care needs in patients with liver cirrhosis using the MELD/Na score and the Child-Pugh score. Materials and Methods: A retrospective study of hospitalized patients with hepatic cirrhosis between January 2015 and December 2016 using the Child-Pugh score and the MELD/Na score in January 2018. Results: Recognizing end-of-life patients (the past 12 months of life) is a challenge for health professionals, especially in diseases with poorly defined criteria, such as cirrhosis of the liver. The verification of rapid functional decline and health indicators can be verified using already defined scales such as the Child-Pugh score and the MELD/Na score. Patients were classified according to the Child-Pugh score in Class A (17%), Class B (48.9%), and Class C (34%). The corresponding survival rate was as follows: class A (87.5%), Class B (30.4%), and Class C (31.25%). The MELD/Na score intervals were >9 (2.15%), score 10-19 (46.8%), score 20-29 (27.7%), score 30-40 (19.1%), and score >40 (4.3%). Nearly 51.1% had a MELD/Na score >20 and 48.9% <20. The study revealed that 59.6% of patients died before 12 months. They were end-of-life patients who needed palliative care to reduce the impact of the disease. Conclusions: The Child-Pugh score and the MELD/Na score represent a viable and easy-to-use tool to identify patients in need of palliative care, among those with liver cirrhosis. Early identification, timely evaluation, and effective treatment of physical, spiritual, family, and social problems improve the quality of life of people with incurable diseases and their families.