Abstract: Objective To investigate the value of the preoperative MELD(model for end-stage liver disease) score in the evaluation of postoperative complications and long-term prognosis in patients with liver hydatid disease. Methods The preoperative MELD scores of various complications in patients with hepatic echinococcosis were compared. The five-year recurrence or death of all patients suffering from hepatic echinococcosis after operation was taken as the state variable and the preoperative MELD score was used as the test variable. The ROC analysis of the two was carried out to obtain the optimal cut-off values for predicting the postoperative survival of patients. The participants were divided into two groups. The general clinical data of patients between the two groups were compared, and the 5-year recurrence free survival rate and overall survival rate of postoperative patients between the two groups were compared by Kaplan-Meier survival analysis. Results In this study, 97 patients with hepatic echinococcosis, 66 males (68.0%) and 31 females (32.0%), aged 27-68 years, with an average age of (43.2 ± 12.6) were enrolled. Major complications included liver dysfunction in 35 (36.1%) cases , biliary fistula in 20 (20.6%) cases, pleural and peritoneal effusion in 32 (33.0%) cases and infection in 16 (16.5%) cases. The preoperative MELD score of patients with postoperative liver dysfunction (12.3 ± 3.1) was significantly higher than that of patients with normal liver function (6.2 ± 1.1) (t/χ²=11.236 / <0.001), ROC analysis showed that the area under the curve (AUC) of preoperative MELD score predicting the postoperative survival value of patients with hepatic hydatid disease was 0.832 (95% CI: 0.754 ~ 0.886), and the optimal cut-off value was 10.3. According to the optimal cut-off value of preoperative MELD score, patients were divided into two groups based on their MELD scores: group A, MELD score ≥ 10.3(n=39, 40.2%) and group B, MELD < 10.3(n=58, 59.8%). Kaplan Meier survival analysis showed that there was no significant difference in the 5-year recurrence- free survival rate of patients between the two groups (78.9%, 58.2%, 56.3% vs 100%, 76.9%, 65.5%, all P>0.05). The 1-year, 3-year and 5-year overall survival rate in group A was significantly lower than that in group B(100%, 75.6%, 63.4% vs 100%, 92.3%, 83.2%, all P<0.05). Conclusion The preoperative MELD score can accurately evaluate the risk of postoperative liver dysfunction and long-term overall survival rate of patients with hepatic echinococcosis.

Key words: Preoperative MELD score, Hepatic hydatid, Postoperative complications, Long-term prognosis