Patient selection: hepatocellular carcinoma
Outcome: survival < 1 month
Clinical factors associated with an extremely poor survival:
(1) high MELD score
(2) regional or metastatic disease (odds ratio 2.4 and 4.1 respectively)
(3) no therapy (a patient may not be treated if the prognosis is very poor)
Laboratory findings associated with poor survival:
(1) high serum alpha-fetoprotein (AFP)
(2) low serum albumin
(3) elevated serum creatinine (which may indicate hepatorenal syndrome or organ failure, significant in univariate analysis but not the multivariate one)
Serum albumin and MELD tended to interact. The table below show the decimal fraction of patients who died in < 1 month for each group.
|
MELD Score
|
Albumin 2.0 g/dL
|
Albumin 2.5 g/dL
|
Albumin 3.0 g/dL
|
|
10
|
0.26
|
0.17
|
0.17
|
|
20
|
0.50
|
0.36
|
0.23
|
|
30
|
0.77
|
0.58
|
0.31
|
|
40
|
0.93
|
0.76
|
0.40
|
If this data is analyzed in Minitab:
decimal fraction for albumin 2.0 g/dL =
= (0.02294 * (MELD)) + 0.0425
decimal fraction for albumin 2.5 g/dL =
= (0.01989 * (MELD)) - 0.0275
decimal fraction for albumin 3.0 g/dL =
= (0.0076 * (MELD)) + 0.0855
