Comparative Predictive Accuracy of Child-Pugh and MELD Scores in Prognosis of Liver Cirrhosis and Evaluation of Serum Ferritin Levels

Abstract

Background: Liver cirrhosis is a leading cause of morbidity and mortality worldwide. Accurate prognostication is crucial for timely interventions and optimal management. Child-Pugh and MELD scores are widely used prognostic tools, but their relative effectiveness remains debated. Aim: To compare the predictive accuracy of Child-Pugh and MELD scores in determining mortality in liver cirrhosis patients and evaluate the prognostic value of serum ferritin levels. Methods: This prospective observational study enrolled 50 patients with liver cirrhosis admitted to a tertiary care hospital between November 2022 and March 2023. Patients were assessed using Child-Pugh and MELD scores at admission and after three months. Serum ferritin levels were measured, and clinical outcomes were recorded. Statistical analysis employed SPSS version 22.0. Results: The majority of patients (46%) were aged 41-60 years, with a male predominance (90%). Jaundice (94%), ascites (38%), and hepatic encephalopathy (16%) were common presentations. The overall mortality rate was 24%. Child-Pugh scores correlated significantly with mortality (p < 0.01). Survival rates for Child-Pugh classes A, B, and C were 100%, 80%, and 45%, respectively. Patients with serum ferritin levels >500 ng/mL had significantly lower survival rates (61%) compared to those with levels <500 ng/mL (88%). The Child-Pugh score demonstrated greater short-term predictive accuracy (AUC = 0.85) compared to the MELD score (AUC = 0.78). Conclusion: This study highlights the importance of Child-Pugh and MELD scores in predicting mortality in liver cirrhosis. Elevated serum ferritin levels (>500 ng/mL) emerge as an independent prognostic marker for poor outcomes. Integration of clinical scoring systems and biomarkers can enhance predictive accuracy and guide therapeutic decision-making. These findings have significant implications for risk stratification, personalized treatment, and liver transplant prioritization. Future research should focus on validating these findings and exploring underlying mechanisms to improve liver cirrhosis management.