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Normothermic Ex Vivo Liver Machine Perfusion in Mouse
Published on: September 25, 2023
Predictive Value of Serial Model of End-Stage Liver Disease Score Determination in Patients with Postcardiotomy
Oliver Sommerfeld1, Caroline Neumann1, Marcel-Dominic Pfeifer1
1Department of Anaesthesiology and Critical Care Medicine, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany.
Abstract:
(1) Background: The use of extracorporeal membrane oxygenation (ECMO) in low cardiac output states after cardiac surgery may aid in patient recovery. However, in some patients, the clinical state may worsen, resulting in multiple organ failure and high mortality rates. In these circumstances, calculating a model of end-stage liver disease (MELD) score was shown to determine organ dysfunction and predicting mortality. (2) Methods: We evaluated whether serial MELD score determination increases mortality prediction in patients with postcardiotomy ECMO support. (3) Results: Statistically, a cutoff of a 2.5 MELD score increase within 48 h of ECMO initiation revealed an AUC of 0.722. Further, we found a significant association between hospital mortality and 48 h MELD increase (HR: 2.5, 95% CI: 1.33-4.75, p = 0.005) after adjustment for possible confounders. (4) Conclusions: Therefore, serial MELD score determinations on alternate days may be superior to single measurements in this special patient cohort.
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