Prognostic Value of Hepatorenal Function By Modified Model for End‐stage Liver Disease (MELD) Score in Patients Undergoing Tricuspid Annuloplasty

Chen, Yan; Liu, Ying‐Xian; Seto, Wai‐Kay; Wu, Mei‐Zhen; Yu, Yu-Juan; Lam, Yui‐Ming; Au, Wing‐Kuk; Chan, Daniel; Sit, Ko‐Yung; Ho, Lai‐Ming; Tse, Hung‐Fat; Yiu, Kai‐Hang

doi:10.1161/jaha.118.009020

Cited by 42 publications

(61 citation statements)

References 35 publications

(47 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Sern Lim 28 found remarkably similar results in a cohort of 26 patients undergoing VA‐ECMO as bridge to transplantation; 69% mortality for patients with a baseline MELD‐XI of 14 or greater compared to 31% for those with a baseline MELD‐XI less than 14. Among all the literature that investigates MELD‐XI in regard to cardiac disease processes, the cutoff value used to define the high‐risk cohort ranged from 10 to 15 11‐26,28 . In our study, the optimal cutoff based on the Youden index was 12.98 and a cutoff of 14 demonstrated significant prognostic value (odds ratio, 4.75; P < .001).…”

Section: Resultsmentioning

confidence: 70%

“…The MELD‐XI score, originally developed to account for the frequent anticoagulation use among cirrhotic patients awaiting transplant, 10 has shown clinical prognostic utility for a number of cardiac disease processes 11‐25 . It is an objective measure that requires only creatinine and total bilirubin values, making it accessible and easy to implement in a clinical setting.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

MELD‐XI is predictive of mortality in venoarterial extracorporeal membrane oxygenation

et al. 2020

View full text Add to dashboard Cite

Background Venoarterial extracorporeal membrane oxygenation (VA‐ECMO) is a life‐saving method of supporting critically ill patients. However, it is expensive and associated with high morbidity and mortality, making early predictive outcome modeling extremely valuable. The model for end‐stage liver disease‐excluding international normalized ratio (MELD‐XI) scoring system has been shown to have prognostic value in other critically ill patient populations. Materials and Methods A single‐center retrospective review was performed for all adult patients managed on VA‐ECMO from May 2011 to January 2018 (n = 247). Patients were included in the study if MELD‐XI scores could be calculated during the first 48 hours on ECMO (n = 187). Receiver operating characteristic curve analysis was performed for MELD‐XI in regard to in‐hospital mortality. Results Of the 187 patients, 74 (40%) patients had MELD‐XI less than 14 (low‐risk) and 113 (60%) had a MELD‐XI of 14 or greater (high‐risk). The cohorts did not differ significantly in terms of patient characteristics or indication for ECMO. The high‐risk MELD‐XI group had significantly greater mortality during index hospitalization compared to the low‐risk group (74% vs 39%; P < .0001). Quartile stratification demonstrated progressively worse prognosis associated with higher MELD‐XI scores; the fourth quartile showed a ninefold increased risk of mortality compared to the first quartile (P < .001). The AUC for predicting index hospitalization mortality was 0.69 (95% CI, 0.62‐0.77) with a Youden index (J) of 0.36 and optimized cutoff of 12.98. Conclusions These findings suggest that the MELD‐XI scoring system can be applied to the VA‐ECMO patient population early in their course of ECMO as a prognostic tool to aid in complex clinical decision making.

show abstract

Section: Resultsmentioning

confidence: 70%

Section: Resultsmentioning

confidence: 99%

MELD‐XI is predictive of mortality in venoarterial extracorporeal membrane oxygenation

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The collapsibility index of the IVC was calculated according to the formula: the difference of maximum and minimum diameter of the IVC divided by the maximum diameter of the IVC [19]. The formulas used for calculating MELD and modified MELD scores have been described previously [11]. ALBI score was calculated according to the equation: ALBI score = (log 10 bilirubin x 0.66) + (albumin x −0.085) and has been previously published [24].…”

Section: Resultsmentioning

confidence: 99%

“…However, the Model for End-Stage Liver Disease (MELD) excluding international normalized ratio (MELD-XI) score is a functional score indicating advanced liver disease that seems to be suitable in the risk assessment of patients with combined cardiac and hepatic dysfunction and even predicts clinical outcomes in congestive liver disease [6,9,10]. Recently, a new MELD-Albumin score including albumin to replace INR in the conventional MELD score has been investigated in patients undergoing tricuspid annuloplasty for severe tricuspid regurgitation revealing to be a prognostic indicator as good as MELD-XI score [11]. Moreover, the ALBI score has been shown to be applicable, robust and superior to the conventional MELD score in the evaluation of the functional status and long-term prognosis of patients with liver cirrhosis [12,13].…”

Section: Introductionmentioning

confidence: 99%

MicroRNA 29c-3p indicates advanced liver fibrosis/cirrhosis in univentricular heart patients with and without Fontan palliation

Abu‐Halima

Meese

Saleh

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: In patients with chronic liver disease that usually results in liver fibrosis, microRNAs (miRNAs) have been shown to be of diagnostic and prognostic value. The present study aims to identify those miRNAs in patients with univentricular heart (UVH) disease with and without Fontan palliation that may be associated with advanced liver fibrosis/cirrhosis. Methods:A large panel of human miRNA arrays were used to determine miRNA abundance profiles in the blood of 48 UVH patients with and without Fontan palliation and 32 age and gender-matched healthy controls. The most abundantly expressed miRNAs identified by microarray analysis were correlated to prognostic scores of advanced liver fibrosis/cirrhosis and selected miRNAs validated by RT-qPCR.Results: According to microarray analysis, 50 miRNAs were found to be significantly abundant in UVH patients of which miR-29b-3p and miR-29c-3p were significantly correlated to the model of end-stage liver disease (MELD)-Albumin and albumin-bilirubin (ALBI) score. According to ROC analysis, a MELD-Albumin score ≥ 11 was best predicted by total bilirubin (AUC 0.985, P=0.005), collapsibility index (AUC 0.952, P=0.009) and miR-29c-3p (AUC 0.941, P=0.011) and the most significant predictors of an ALBI score >−2.6 were collapsibility index (AUC 0.998, P<0.001) and albumin (AUC 0.981, P=0.006).In the multivariate analysis, miR-29c-3p turned out to be an independent predictor of advanced liver fibrosis/cirrhosis as defined by a MELD-Albumin score ≥ 11 (P=0.004) and ALBI score > −2.6 (P=0.009), respectively. Conclusion:In UVH patients with and without Fontan palliation, miR-29c-3p seems to be an independent predictor of advanced liver fibrosis/cirrhosis and thus may be used in the risk assessment of these patients.

show abstract

“…Furthermore, the MELD-Albumin score, which replaces the INR with serum albumin, is a useful predictor of clinical outcomes after heart transplantation and various heart valve interventions [11,12]. We investigated the predictive value of the MELD-Albumin score for mortality within 30 days of admission to an ICU in patients with high-risk APE.…”

Section: Introductionmentioning

confidence: 99%

MELD-Albumin score predicts 30-day mortality in high-risk patients with acute pulmonary embolism admitted to intensive care units

İdin¹,

Dereli²,

Yenerçağ³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The Model for End-stage Liver Disease excluding the international normalised ratio (INR, MELD-XI) and modified MELD, which uses albumin in place of the INR (MELD-Albumin) scores reflect liver and renal function and are predictors of mortality. However, their prognostic value in acute pulmonary embolism (APE) has not been studied.Methods: We assessed the predictive value of the MELD scores in patients diagnosed with high-risk APE admitted to the intensive care unit (ICU). The primary outcome was 30-day mortality.Results: Of the 273 patients included in the study, 231 were survivors and 42 were non-survivors. The mortality rate was 15.3%. The mean Meld-XI and MELD-Albumin scores were significantly higher in the non-survivors than in the survivors (MELD XI, 11.8 ± 1.8 and 10.6 ± 1.43, respectively; p = 0.002; MELD-Albumin, 10.5 ± 1.6 and 8.7 ± 1.1, respectively; p = 0.001). The multiple logistic regression analysis identified the MELD-XI (hazard ratio [HR]: 3.029, confidence interval [CI]: 1.06–1.21, p = 0.007) and MELD-Albumin (HR: 1.13, CI: 1.06–1.21, p = 0.002) scores as independent predictors of mortality. Receiver operating characteristic analysis revealed that the predictive power of the MELD-Albumin score (0.871 ± 0.014; p < 0.001) was higher than those of the MELD-XI (0.726 ± 0.022, p < 0.001), APACHE III (0.682 ± 0.024, p < 0.001), and PESI (0.624 ± 0.023, p < 0.001) scores.Conclusions: The MELD-Albumin score is an easily calculable, reliable, and practical risk assessment tool and independent predictor of 30-day mortality in patients with high-risk APE.

show abstract

Prognostic Value of Hepatorenal Function By Modified Model for End‐stage Liver Disease (MELD) Score in Patients Undergoing Tricuspid Annuloplasty

Cited by 42 publications

References 35 publications

MELD‐XI is predictive of mortality in venoarterial extracorporeal membrane oxygenation

MELD‐XI is predictive of mortality in venoarterial extracorporeal membrane oxygenation

MicroRNA 29c-3p indicates advanced liver fibrosis/cirrhosis in univentricular heart patients with and without Fontan palliation

MELD-Albumin score predicts 30-day mortality in high-risk patients with acute pulmonary embolism admitted to intensive care units

Contact Info

Product

Resources

About