Related Experiment Video
Updated: Oct 5, 2025
Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
Published on: December 27, 2024
Preoperative MELD score predicts adverse outcomes following gastrectomy: An ACS NSQIP analysis
Hussein H Khachfe1, Tarek Z Araji2, Hasan Nassereldine3
1Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Background:
The Model End-Stage Liver Disease (MELD) has been widely used to predict the mortality and morbidity of various surgical procedures. We aimed to assess the impact of preoperative MELD score on adverse 30-day postoperative outcomes following gastrectomy.
Methods:
Patients who underwent elective, non-emergent gastrectomy were identified from the ACS NSQIP 2014-2019 database. Patients were categorized according to a calculated MELD score. The primary outcomes of this study were the 30-day overall complications and major complication rates following gastrectomy.
Results:
Compared to MELD <11, patients with MELD ≥11 had significantly higher rates of mortality, any complication, and major complication. MELD score ≥11 was significantly associated with any complication (OR 1.73, p = 0.011) and major complications (1.85, p = 0.014) on multivariate analysis.
Conclusions:
MELD score ≥11 was associated with poorer outcomes in patients undergoing gastrectomy compared to lower MELD scores.
Insights
A higher Model End-Stage Liver Disease (MELD) score (≥11) significantly increases the risk of 30-day complications and mortality after gastrectomy surgery. Patients with MELD scores below 11 experienced better outcomes.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Medical Informatics
Background:
- The Model End-Stage Liver Disease (MELD) score is a validated tool for predicting patient outcomes in various surgical contexts.
- Gastrectomy, a major surgical procedure for stomach conditions, carries inherent risks that necessitate accurate preoperative risk assessment.
Purpose of the Study:
- To evaluate the association between preoperative Model End-Stage Liver Disease (MELD) scores and adverse 30-day postoperative outcomes in patients undergoing gastrectomy.
- To determine if elevated MELD scores predict increased complication rates and mortality post-gastrectomy.
Main Methods:
- Analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2014 to 2019.
- Inclusion of patients who underwent elective, non-emergent gastrectomy, categorized by their calculated MELD score.
- Assessment of 30-day overall and major complication rates as primary outcomes.
Main Results:
- Patients with a MELD score of 11 or higher demonstrated significantly higher rates of mortality, overall complications, and major complications compared to those with MELD <11.
- Multivariate analysis confirmed that a MELD score ≥11 was independently associated with increased odds of any complication (OR 1.73) and major complications (OR 1.85).
Conclusions:
- A preoperative MELD score of 11 or greater is a significant predictor of adverse outcomes following gastrectomy.
- Elevated MELD scores indicate a higher risk profile, guiding preoperative risk stratification and patient counseling for gastrectomy.
Related Concept Videos
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management