IN-HOSPITAL MORTALITY IN CIRRHOSIS IS RELATED TO NOSOCOMIAL INFECTIONS INDEPENDENT OF MELD SCORE: THE NORTH AMERICAN CONSORTIUM FOR THE STUDY OF END-STAGE LIVER DISEASE (NACSELD) STUDY

2012 ◽  
Vol 56 ◽  
pp. S242 ◽  
Author(s):  
J.S. Bajaj ◽  
J.G. O'Leary ◽  
K.R. Reddy ◽  
J.C. Olson ◽  
F. Wong ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hospital Mortality ◽  
North American ◽  
Nosocomial Infections ◽  
Meld Score ◽  
End Stage Liver Disease ◽  
The North ◽  
End Stage

scholarly journals The use of MELD scores in critically ill cirrhotic patients

2016 ◽  
Vol 4 (16) ◽  
pp. 45
Author(s):  
Supannee Rassameehiran ◽  
Tinsay Woreta
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Hospital Mortality ◽  
Organ Failure ◽  
Critically Ill ◽  
Meld Score ◽  
Chronic Liver Failure ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
End Stage

The Model for End-Stage Liver Disease (MELD) was originally created to predict survival following transjugular intrahepatic portosystemic shunt and was subsequently found to accurately predict mortality in patients with end-stage liver disease. It has been used in the United States for liver allocation since 2002, and implementation of the MELD score resulted in a reduction in total number of deaths on the waitlist and a reduction in waiting time. Critically ill cirrhotic patients have an in-hospital mortality greater than 50%. Although the MELD score was also found to be an accurate predictor of in-ICU mortality and in-hospital mortality after ICU admission in critically ill cirrhotic patients, the Sequential Organ Failure Assessment (SOFA) score appears to perform better in many studies. The Chronic Liver Failure Consortium Acute-on-Chronic Liver Failure (CLIF-C ACLF) score was later developed by using specific cut-points for each organ failure score system in CLIF patients to predict mortality in patients with ACLF. Neither the MELD nor SOFA score independently predicts post-liver transplantation mortality in cirrhotic patients with extrahepatic organ failure and should not be use as a delisting criterion for these patients. More data are needed to determine the accuracy of the CLIF-C ACLF score in predicting post-liver transplantation outcomes. Prospective evaluation of critically ill cirrhotic patients is needed to optimize liver organ allocation.

scholarly journals Second infections independently increase mortality in hospitalized patients With cirrhosis: the north american consortium for the study of end-stage liver disease (NACSELD) experience

Hepatology ◽  
2012 ◽  
Vol 56 (6) ◽  
pp. 2328-2335 ◽  
Author(s):  
Jasmohan S. Bajaj ◽  
Jacqueline G. O'Leary ◽  
K. Rajender Reddy ◽  
Florence Wong ◽  
Jody C. Olson ◽  
...  
Keyword(s):  
Liver Disease ◽  
North American ◽  
Hospitalized Patients ◽  
End Stage Liver Disease ◽  
The North ◽  
End Stage

scholarly journals High risk of delisting or death in liver transplant candidates following infections: Results from the North American consortium for the study of end-stage liver disease

2015 ◽  
Vol 21 (7) ◽  
pp. 881-888 ◽  
Author(s):  
K. Rajender Reddy ◽  
Jacqueline G. O'Leary ◽  
Patrick S. Kamath ◽  
Michael B. Fallon ◽  
Scott W. Biggins ◽  
...  
Keyword(s):  
Liver Disease ◽  
High Risk ◽  
Liver Transplant ◽  
North American ◽  
End Stage Liver Disease ◽  
The North ◽  
Transplant Candidates ◽  
End Stage

scholarly journals Model of End-Stage Liver Disease (MELD) Score as a Predictor of In-Hospital Mortality in Patients with COVID-19: A Novel Approach to a Classic Scoring System

Cureus ◽  
2021 ◽  
Author(s):  
Peter M Stawinski ◽  
Karolina N Dziadkowiec ◽  
Baher Al-Abbasi ◽  
Laura Suarez ◽  
Larnelle Simms ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hospital Mortality ◽  
Scoring System ◽  
Meld Score ◽  
End Stage Liver Disease ◽  
Novel Approach ◽  
End Stage

scholarly journals Comparison of model for end-stage liver disease-Na score and model for end-stage liver disease score in predicting in-hospital mortality in patients with end stage liver disease: an observational study

2019 ◽  
Vol 6 (3) ◽  
pp. 932
Author(s):  
Tirthankar Mukherjee ◽  
Kamalesh Tagadur Nataraju ◽  
B. M. Rakesh ◽  
Soumya Dattanagowda Dandothi
Keyword(s):  
Liver Disease ◽  
Observational Study ◽  
Hospital Mortality ◽  
Meld Score ◽  
End Stage Liver Disease ◽  
Survivor Group ◽  
Intrahepatic Portosystemic Shunt ◽  
Study Population ◽  
The Mean ◽  
End Stage

Background: Model for end-stage liver disease (MELD) score was originally developed to predict mortality after trans jugular intrahepatic portosystemic shunt. Hyponatremia is the most common electrolyte abnormality in end stage liver disease (ESLD). Incorporating serum sodium into MELD score increases its predictive accuracy.Methods: This is an observational study conducted on 50 patients of ESLD admitted from October 2012 to September 2014. Study population was divided into survivor and non-survivor groups. MELD score and MELD-Na score was calculated and compared between the groups.Results: Out of 50 participants, 20 (40%) died in the hospital due to cirrhosis related complications.  The average age was 44.7±12.040 years in the survivor group and 54.1±9.910 years in the non-survivor group. The mean MELD score and MELD-Na score was found to be higher in non-survivors group (28.5 and 30.5) compared to survivors group (22.03 and 25.67) which was statistically very significant. Majority of the patients in survivor group had MELD score between 10-19 (43.3%) and 30-39 (36.7%). In the non-survivor group majority of patients had score of more than 20 (80%). MELD-Na score has better sensitivity (90%) compared to MELD score (80%) at a cut off value above 22. However, MELD score has better specificity (60%) compared to MELD-Na score (43.3%) at the same cut off value.Conclusions: MELD-Na score was higher in non-survivor group with good predictability for in-hospital mortality and there was good correlation between both the scores in terms of degree of agreement and MELD-Na score was more sensitive compared to MELD score.

scholarly journals USEFULNESS OF MELD SCORE IN PREDICTING IN - HOSPITAL MORTALITY IN PAT I ENTS WITH END STAGE LIVER DISEASE: AN OBSERVATIONAL STUDY

2015 ◽  
Vol 4 (45) ◽  
pp. 7734-7740
Author(s):  
Keshava H K ◽  
Chikkalingaiah Chikkalingaiah ◽  
Kamalesh T N ◽  
Vinayaka G P ◽  
Shashidhar B
Keyword(s):  
Liver Disease ◽  
Observational Study ◽  
Hospital Mortality ◽  
Meld Score ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals COVID-19 in liver transplant candidates: pretransplant and post-transplant outcomes - an ELITA/ELTR multicentre cohort study

Gut ◽  
2021 ◽  
pp. gutjnl-2021-324879
Author(s):  
Luca Saverio Belli ◽  
Christophe Duvoux ◽  
Paolo Angelo Cortesi ◽  
Rita Facchetti ◽  
Speranta Iacob ◽  
...  
Keyword(s):  
Liver Disease ◽  
Respiratory Failure ◽  
Meld Score ◽  
Decompensated Cirrhosis ◽  
Cox Regression Analysis ◽  
Post Transplant ◽  
End Stage Liver Disease ◽  
Significant Difference ◽  
End Stage ◽  
The Impact

ObjectiveExplore the impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course.DesignData from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and were analysed.ResultsFrom 21 February to 20 November 2020, 136 adult cases with laboratory-confirmed SARS-CoV-2 infection from 33 centres in 11 European countries were collected, with 113 having COVID-19. Thirty-seven (37/113, 32.7%) patients died after a median of 18 (10–30) days, with respiratory failure being the major cause (33/37, 89.2%). The 60-day mortality risk did not significantly change between first (35.3%, 95% CI 23.9% to 50.0%) and second (26.0%, 95% CI 16.2% to 40.2%) waves. Multivariable Cox regression analysis showed Laboratory Model for End-stage Liver Disease (Lab-MELD) score of ≥15 (Model for End-stage Liver Disease (MELD) score 15–19, HR 5.46, 95% CI 1.81 to 16.50; MELD score≥20, HR 5.24, 95% CI 1.77 to 15.55) and dyspnoea on presentation (HR 3.89, 95% CI 2.02 to 7.51) being the two negative independent factors for mortality. Twenty-six patients underwent an LT after a median time of 78.5 (IQR 44–102) days, and 25 (96%) were alive after a median follow-up of 118 days (IQR 31–170).ConclusionsIncreased mortality in LT candidates with COVID-19 (32.7%), reaching 45% in those with decompensated cirrhosis (DC) and Lab-MELD score of ≥15, was observed, with no significant difference between first and second waves of the pandemic. Respiratory failure was the major cause of death. The dismal prognosis of patients with DC supports the adoption of strict preventative measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%).

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