The utility of the MELD score in predicting mortality following liver resection for metastasis

Fromer, Marc W.; Aloia, Thomas A.; Gaughan, John; Atabek, Umur; Spitz, Francis R.

doi:10.1016/j.ejso.2016.05.035

Cited by 12 publications

(13 citation statements)

References 59 publications

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“…The MELD score was originally introduced as an assessment measure for the intensity of chronic liver conditions, but can also calculate the risks of hepatectomy in patients with liver metastasis 32 . Mortality risk was more than two times higher in patients with a MELD score > 7.24 33 . This index has also been validated for post-hepatectomy complications in cirrhotic patients with hepatocellular carcinoma (AUC = 0.85) 33,34 .…”

Section: Aprimentioning

confidence: 89%

“…Mortality risk was more than two times higher in patients with a MELD score > 7.24 33 . This index has also been validated for post-hepatectomy complications in cirrhotic patients with hepatocellular carcinoma (AUC = 0.85) 33,34 . Data from the present study supports the significant accuracy of the MELD score in predicting mortality after EH (AUC = 0.690).…”

Section: Aprimentioning

confidence: 89%

“…www.nature.com/scientificreports www.nature.com/scientificreports/ developed by Breitenstein et al 31 , liver fibrosis (FIB-4) index 12,30 , Heidelberg score 29 , and MELD score 33 . Risk assessment scores are presented in Table 3.…”

Section: Determination Of Well-known Risk Scoresmentioning

confidence: 99%

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Comparative Analysis of the Discriminatory Performance of Different Well-Known Risk Assessment Scores for Extended Hepatectomy

Ghamarnejad

Khajeh

Rezaei

et al. 2020

Sci Rep

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The aim of this study was to assess and compare the discriminatory performance of well-known risk assessment scores in predicting mortality risk after extended hepatectomy (EH). A series of 250 patients who underwent EH (≥5 segments resection) were evaluated. Aspartate aminotransferase-to-platelet ratio index (APRI), albumin to bilirubin (ALBI) grade, predictive score developed by Breitenstein et al., liver fibrosis (FIB-4) index, and Heidelberg reference lines charting were used to compute cutoff values, and the sensitivity and specificity of each risk assessment score for predicting mortality were also calculated. Major morbidity and 90-day mortality after EH increased with increasing risk scores. APRI (86%), ALBI (86%), Heidelberg score (81%), and FIB-4 index (79%) had the highest sensitivity for 90-day mortality. However, only the FIB-4 index and Heidelberg score had an acceptable specificity (70% and 65%, respectively). A two-stage risk assessment strategy (Heidelberg-FIB-4 model) with a sensitivity of 70% and a specificity 86% for 90-day mortality was proposed. There is no single specific risk assessment score for patients who undergo EH. A two-stage screening strategy using Heidelberg score and FIB-4 index was proposed to predict mortality after major liver resection.

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Section: Aprimentioning

confidence: 89%

Section: Aprimentioning

confidence: 89%

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Comparative Analysis of the Discriminatory Performance of Different Well-Known Risk Assessment Scores for Extended Hepatectomy

Ghamarnejad

Khajeh

Rezaei

et al. 2020

Sci Rep

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“…The labMELD and P-POSSUM scoring systems are well-established, frequently used and have been developed or validated in large patient cohorts [7,[9][10][11][12][13][14][25][26][27][28]. The MELD Score showed heterogenic predictive power in varying cohorts of patients undergoing hepatectomy [29,30]. The P-POSSUM scoring systems include patient's physiological condition and operative parameters and were found suitable for predicting postoperative mortality after hepato-biliarypancreatic surgery [6].…”

Section: Performance Of Labmeld Score and P-possum Scores According Tmentioning

confidence: 99%

Comparison of score-based prediction of 90-day mortality after liver resection

et al. 2020

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Background: Indications for liver surgery are expanding fast and complexity of procedures increases. Preoperative mortality risk assessment by scoring systems is debatable. A previously published externally validated Mortality Risk Score allowed easy applicable and precise prediction of postoperative mortality. Aim of the study was to compare the performance of the Mortality Risk Score with the standard scores MELD and P-POSSUM. Methods: Data of 529 patients undergoing liver resection were analysed. Mortality Risk Score, the labMELD Score and the P-POSSUM Scores (PS, OS, P-POSSUM mortality %) were calculated. The ROC curves of the three scoring systems were computed and the areas under the curve (C-index) were calculated using logistic regression models. Comparisons between the ROC curves were performed using the corresponding Wald tests. Results: Internal validation confirmed that the risk model was predictive for a 90-day mortality rate with a C-index of 0.8421. The labMELD Score had a C-index of 0.7352 and the P-POSSUM system 0.6795 (PS 0.6953, OS 0.5413). The 90-day mortality rate increased with increasing labMELD values (p < 0.0001). Categorized according to the Mortality Risk Score Groups the labMELD Score showed a linear increase while the POSSUM Scores showed variable results. Conclusions: By accurately predicting the risk of postoperative mortality after liver surgery the Mortality Risk Score should be useful at the selection stage. Prediction can be adjusted by use of the well-established labMELD Score. In contrast, the performance of standard P-POSSUM Scores is limited.

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“…The Model for End-stage Liver Disease (MELD) was initially constructed as a predictor of mortality following transjugular intrahepatic portosystemic shunts (TIPS) and has been adopted as a measure of liver dysfunction for transplantation(21, 22). Preoperative MELD score has been identified as a predictor of PHLI, but it is limited in sensitivity and specificity, particularly when applied to patients without cirrhosis(6, 23–25). Postoperative parameters, such as the 50–50 criteria which uses prothrombin time <50% and bilirubin >50 µmol/L on postoperative day five as significant predictors of mortality, have also been used to predict PHLI but are not helpful for identifying high-risk patients prior to operation(2, 26).…”

Section: Introductionmentioning

confidence: 99%

Quantitative Imaging Features and Postoperative Hepatic Insufficiency: A Multi-Institutional Expanded Cohort

Pak

Chakraborty

Gönen

et al. 2018

Journal of the American College of Surgeons

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The utility of the MELD score in predicting mortality following liver resection for metastasis

Cited by 12 publications

References 59 publications

Comparative Analysis of the Discriminatory Performance of Different Well-Known Risk Assessment Scores for Extended Hepatectomy

Comparative Analysis of the Discriminatory Performance of Different Well-Known Risk Assessment Scores for Extended Hepatectomy

Comparison of score-based prediction of 90-day mortality after liver resection

Quantitative Imaging Features and Postoperative Hepatic Insufficiency: A Multi-Institutional Expanded Cohort

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