Model for End-Stage Liver Disease Excluding INR Is Associated with Poor Prognosis in Elderly Patients with...

Introduction: Heart failure (HF) remains a leading cause of morbidity and hospitalization among elderly patients. Therefore, identifying reliable prognostic indicators is crucial for improving clinical outcomes in this population. The aim of this study was to evaluate the association between the Model for End-stage Liver Disease excluding INR (MELD-XI) and clinical outcomes in elderly patients hospitalized for decompensated HF. Material and methods: This was a single-center observational study involving 242 elderly patients with end-stage HF who were hospitalized for decompensation at our institution between 2019 and 2023. Upon hospital admission and discharge, MELD-XI scores were calculated using serum bilirubin and creatinine levels. The primary endpoint of the study was all-cause mortality during the follow-up period. Results: The median age of the patients was 68 years (66-74.6), and 78.9% were men. The median (Q1-Q3) follow-up time was 1.47 (0.78-2.31) years. During the follow-up period, 47.1% of the patients died. Independent predictors of mortality were diabetes mellitus [HR 1.656 (1.113-2.463), p = 0.013] and MELD-XI at discharge [OR 1.267 (1.210-1.327), p < 0.001]. The area under the receiver operating characteristic curves (AUC) for MELD-XI at discharge was 0.827 (95% CI: 0.776-0.878). The cut-off value for MELD-XI at discharge (>11.7 points) had a sensitivity of 97% and a specificity of 59%. Conclusions: Independent predictors of death in the analyzed population of elderly patients with decompensated HF were diabetes mellitus and MELD-XI at discharge.