末期肝病得分模型预测左心室辅助器械手术输血需求,发病率和死亡率
Jennifer C Matthews1, Francis D Pagani, Jonathan W Haft
1Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI 48109-5853, USA. jennmatt@umich.edu
Circulation
|January 6, 2010
概括
末期肝病模型 (MELD) 评分有效预测接受左心室辅助器件的患者的高出血和死亡风险. 这一分数有助于评估这些关键患者的外科治疗结果.
科学领域:
- 心脏病学 心脏病学
- 肝病学 肝病学是一种肝病学.
- 外科手术的结果
背景情况:
- 末期肝病模型 (MELD) 评分是为预测接受重大手术的肝硬化患者的结果而建立的.
- 它的实用性可以扩展到左心室辅助器件 (LVAD) 候选人,具有类似的多系统功能障碍.
研究的目的:
- 调查手术前MELD得分对LVAD候选人的术后结果的预测能力.
- 为了比较不同患者队伍的MELD得分表现.
主要方法:
- 来自密歇根大学卫生系统 (UMHS) 和机械辅助循环支持 (INTERMACS) 数据库的机构间注册表的LVAD候选人的回顾性分析.
- 使用回归分析计算手术前MELD得分和评估与手术前血液产品暴露和手术后死亡率的相关性.
主要成果:
- 平均MELD得分为13.7 (UMHS) 和15.2 (INTERMACS),术后死亡率分别为14%和6%.
- 每增加5个单位的MELD与更大的血液产品暴露和增加手术死亡的几率有关.
- 在两个队列中,MELD得分显示出预测外科手术后死亡率的显著能力.
结论:
- MELD评分是识别患有术后出血和死亡风险较高的LVAD候选人的一个有价值的工具.
- 术前MELD评估可以帮助对LVAD植入进行风险分层和管理计划.
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