Impact of model for end-stage liver disease (MELD) score for mortality in patients undergoing coronary bypass surgery

Area of Science:

• Cardiology
• Surgical Outcomes
• Predictive Analytics

Background:

• Coronary artery bypass graft (CABG) surgery is a common procedure for stable angina pectoris.
• Accurate prediction of postoperative mortality is crucial for patient management and surgical decision-making.
• Existing risk scores may not fully capture mortality risk in all patient populations undergoing CABG.

Purpose of the Study:

• To evaluate the predictive capability of the Model for End-Stage Liver Disease (MELD) score for 12-month all-cause mortality in patients with stable angina undergoing CABG.
• To assess whether incorporating the MELD score improves the prognostic performance of the established EuroSCORE II.

Main Methods:

• A retrospective analysis of 261 consecutive patients with stable angina pectoris who underwent CABG without anticoagulant therapy.
• Patients were stratified into survivors and non-survivors based on 12-month postoperative mortality.
• The MELD score was calculated for all participants, and its association with mortality was analyzed.

Main Results:

• Non-survivors were significantly older and had a higher MELD score compared to survivors (p<0.001 for both).
• The MELD score was identified as an independent predictor of one-year postoperative mortality (p=0.001).
• Adding the MELD score to EuroSCORE II significantly improved its prognostic performance, increasing the AUC from 0.792 to 0.842.

Conclusions:

• The MELD score demonstrates utility in predicting mortality risk for patients with stable coronary artery disease undergoing CABG surgery.
• The MELD score can enhance the accuracy of existing risk stratification tools like EuroSCORE II for CABG patients.
• These findings suggest MELD score integration into risk assessment protocols for CABG candidates.