Pretransplant predictors of early mortality in adult recipients of liver transplantation in the MELD-Na Era

Pozo-Laderas, Juan Carlos; Rodríguez‐Perálvarez, Manuel; Muñoz-Villanueva, María Carmen; Rivera-Espinar, Francisco; Durban-García, I.; Muñoz-Trujillo, J.; Robles-Arista, J.C.; Briceño-Delgado, Javier

doi:10.1016/j.medine.2019.04.004

Cited by 2 publications

(2 citation statements)

References 37 publications

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“…MELD score is now replaced with MELD-Na which also takes into account of hyponatremia in these patients and has been shown much superior in predicting mortality as compared to MELD. 18 , 19 …”

Section: Discussionmentioning

confidence: 99%

Assessment of frailty in cirrhosis using bedside measures and its correlation with Child-Turcotte-Pugh, MELD & MELD-Na Scores

et al. 2022

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Objectives: To assess frailty in cirrhotic by calculating Liver Frailty Index (LFI) using bedside clinical tests and correlate it with Child-Turcotte-Pugh (CTP), MELD, MELD Na, Fib- 4 and Transient Elastography (TE) scores Methods: This cross-sectional observational comparative study was carried out in Dr Ruth KM Pfau Civil Hospital, Karachi from August 2020 to September 2021. Patients were subjected to three performance-based testing including dominant hand grip strength (HGS), Chair to Stand (CTS) Time & Three Position Balance (TPB). LFI was calculated using the online LFI calculator, available at http://liverfrailtyindex.ucsf.edu and classified as ‘Robust’ if LFI <3.2, ‘Prefrail’ LFI between 3.2 and 4.4, and ‘Frail’ as LFI ≥4.5. Correlation of frailty with MELD, MELD-Na and CTP Scores was done. Means of MELD & MELD-Na Scores and CTP scores were calculated in all 3 classes of frailty using one way ANOVA. A p-value of ≤.05 was taken as significant. Results: Out of 118 patients, 62 (52.5%) were males. Mean MELD score was 11.4 ±3.3, MELD-Na was 15.97 ±8.54, CTP 8.25 ±2.21, Fib-4 was 2.79 ±1.034 and TE score was 18.20 ±9.17. Mean LFI was 3.87 ±1.07; mean HGS was 18.12 ±4.68; mean of CTS was 9.62 ±3.55. LFI Class distribution in our cohort showed Robust were 36 (30.5%), Prefrail 34 (28.8%) and Frail were 48 (40.8%). Correlation of all these variables with LFI showed significant correlation with LFI, but highest correlation coefficient was seen with MELD-Na. Conclusion: Significant correlation between frailty score in cirrhotic with cirrhosis severity scores highlights the need for frequently assessing LFI in all cirrhotic at regular follow up visits. doi: https://doi.org/10.12669/pjms.38.5.5545 How to cite this:Zuberi BF, Rasheed T, Ali FS, Bader N, Sadaf R. Assessment of frailty in cirrhosis using bedside measures and its correlation with Child-Turcotte-Pugh, MELD & MELD-Na Scores. Pak J Med Sci. 2022;38(5):---------. doi: https://doi.org/10.12669/pjms.38.5.5545 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Assessment of frailty in cirrhosis using bedside measures and its correlation with Child-Turcotte-Pugh, MELD & MELD-Na Scores

et al. 2022

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“…7 In a study by Laderas et al it was noted that the MELD-Na score (OR=1.069, 95% CI=1.014-1.127), age >60 years (OR=2.479, 95% CI=1.226-5.015), and LTR height<163 cm (OR=4.092, 95% CI=2.115-7.917) were identified as independent predictors of early mortality. 8 In observational study by Mukherjee et al it was noted that the non-survivors' mean MELD score and MELD-Na score were found to be higher (28.5 and 30.5) than the survivors' community (22.03 and 25.67), which was statistically important, there was a good correlation between both scores in terms of degree of agreement, with MELD-Na score being more sensitive than MELD score. 9 In a study by Mazumder et al it was noted that during the study period, 2137 (27%) patients died, with higher mortality rates for patients in the high MELD-Na category (19.4 (41.6%) versus 4.1 (12.6%) per 100 person-y, p=0.001).…”

Section: Introductionmentioning

confidence: 92%

Comparison of the model for end-stage liver disease and disease sodium values in prognosticating short term 3-month mortality in chronic liver disease

Nandalike¹,

Fathima

Reddy³

et al. 2022

Int J Res Med Sci

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Background: Chronic liver disease (CLD) cirrhosis of liver is one of the common non communicable disease, accounting for significant morbidity and mortality in developing countries like India. several prognostic scoring systems have evolved from the need to prioritize patients for liver transplantation model for end-stage liver disease (MELD) and its variant, which includes sodium values (MELD-Na) have been recently popularized.Methods: Prospective observational study with follow-up telephone call every month for 3 months, with ppurposive sampling done on 60 patients admitted to AIMS BG Nagara Mandya district Karnataka India. Statistical analysis included the strength of association was assessed using Pearson's correlation and the ROC curve was drawn to assess the accuracy and diagnostic utility of the two models. A p<0.05 was considered statistically significant.Results: In the present study, the mean age of patients was 49.68±9.89 years of age. The strength of association between the MELD score and MELD-Na score was found to be a very strong positive strength of association (r=0.904, p<0.05). 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.Conclusions: MELD-Na score was higher among the patients with outcome of death compared to the MELD score among the patient. The ROC curve showed a comparable result with MELD and MELD-Na scores. There was a relation of severity of hyponatremia with the child-Pugh scores.

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Pretransplant predictors of early mortality in adult recipients of liver transplantation in the MELD-Na Era

Cited by 2 publications

References 37 publications

Assessment of frailty in cirrhosis using bedside measures and its correlation with Child-Turcotte-Pugh, MELD & MELD-Na Scores

Assessment of frailty in cirrhosis using bedside measures and its correlation with Child-Turcotte-Pugh, MELD & MELD-Na Scores

Comparison of the model for end-stage liver disease and disease sodium values in prognosticating short term 3-month mortality in chronic liver disease

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