Hepatic dysfunction in ambulatory patients with heart failure: application of the MELD scoring system for outcome prediction.

摘要: Objectives This study evaluated the Model for End-Stage Liver Disease (MELD) score and its modified versions, which are established measures of liver dysfunction, as a tool to assess heart transplantation (HTx) urgency in ambulatory patients with failure. Background abnormalities have prognostic impact on outcome advanced Methods We retrospectively 343 undergoing HTx evaluation between 2005 2009. The effectiveness MELD 2 modifications (MELDNa [includes serum sodium levels] MELD-XI [does not include international normalized ratio]) endpoint events, defined death/HTx/ventricular assist device requirement, was our cohort subgroups off oral anticoagulation. Results MELDNa scores were excellent predictors 1-year events (areas under curve: 0.71 0.73, respectively). High (>12) strongly associated poor survival at 1 year (MELD 69.3% vs. 90.4% [p < 0.0001]; 70.4% 96.9% 0.0001]). Increased increased risk (hazard ratio: 1.10 [95% confidence interval: 1.06 1.14]; p 0.0001 both scores), independent other known factors ¼ 0.0055; 0.0083). Anticoagulant use (73.7% 86.4%; 0.0118), statistical significance MELD/MELDNa higher receiving anticoagulation therapy. fair but limited predictor Conclusions Assessment dysfunction according scoring system provides additional information (J Am Coll Cardiol 2013;61:2253–61) 2013 by American College Cardiology Foundation