Association of Model for End-Stage Liver Disease Score and Mortality in Trauma Patients With Chronic Liver Disease

Abstract

A decrease in MELD score within 72 hours of ICU admission is associated with improved mortality.

Association of Model for End-Stage Liver Disease Score With Mortality in Emergency General Surgery Patients

“…Based on prior studies, 7,35 we assumed that 90-day mortality would increase an absolute 17.7% in patients with a MELD score of 20 to 29 (25%) compared with those with a MELD score lower than 9.9 (12.5%). With an α error level of 5% and a power of 80%, the minimum sample size thus required for our primary end point was 336 patients.…”

“…The MELD score, first used to predict survival in patients undergoing transjugular intrahepatic portosystemic shunts, 21 has been used extensively in the United States and Europe as a tool for the prioritization of liver transplants. 22 More recently, researchers have identified an association between MELD score and mortality in trauma patients 7 and major complications in cirrhotic patients undergoing emergency hernia repair. 36 This growing body of evidence suggests that MELD scores may be important in predicting outcomes among a wide variety of patients not receiving a transplant.…”

“…This association has also been described in trauma patients. 7 As there are 3 laboratory components to the MELD score (serum bilirubin level, serum creatinine level, and INR), the association between a change in MELD score and 90-day mortality may reflect changes in liver or renal function in the first 48 hours of critical care. Among the 3 variables of the MELD score, INR has the highest multiplicative value, followed by creatinine level.…”

“…17,18 The RPDR has been previously used in clinical research studies in critically ill patients. 7,19,20 Approval for the study was granted by the Partners Human Research Committee. Requirement for informed consent was waived as the data were analyzed anonymously.…”

MELD Scoring System: How Golden Is The Gold

“…Even though this system was moulded to foresee mortality following TIPS, later it was also enacted to stratify patients ahead of liver transplantation, to predict perioperative mortality post-transplant. Lately, researchers have found a notable link allying MELD score and mortality in trauma surgery patients [5].…”