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MELD-based indices as predictors of mortality in chronic liver disease patients who undergo emergency surgery with general anesthesia

 Sung Hoon Kim  ;  Yoon Dae Han  ;  Kyung Sik Kim  ;  Jin Sub Choi  ;  Gi Hong Choi  ;  Sae Byeol Choi  ;  Do Young Kim  ;  Jae Gil Lee 
 Journal of Gastrointestinal Surgery, Vol.15(11) : 2029-2035, 2011 
Journal Title
 Journal of Gastrointestinal Surgery 
Issue Date
BACKGROUND: Underlying chronic liver disease is associated with high morbidity and mortality after emergency surgery, which complicates clinical decisions over performing such surgery. In addition, the Child-Turcotte-Pugh (CTP) score is limited in its ability to predict postoperative residual liver function. This study was designed to determine whether the scores of the Model for End-stage Liver Disease (MELD)-based indices are effective predictors of mortality following emergency surgery in patients with chronic liver disease. METHOD: Medical records of 53 chronic liver disease patients who underwent emergency surgery under general anesthesia from 2001 to 2008 were analyzed retrospectively. RESULTS: Median preoperative CTP score was 6 (5-12); MELD, 11 (6-33); MELD-Na, 15 (7-34); integrated MELD (iMELD), 33 (14-64); and MELD to sodium ratio, 8 (4-24). During a median 11-month follow-up period, 19 (35.8%) patients died. Five of them (26.3%) had operative mortality (i.e., mortality within 30 days after surgery). On multivariate analysis, CTP class C was correlated with operative mortality, and estimated blood loss above 300 ml and the iMELD score above 35 were significantly correlated with overall mortality. CONCLUSIONS: iMELD reflects underlying liver function and predicts overall mortality more accurately than CTP and other MELD-based indices scores do in chronic liver disease patients after emergency surgery with general anesthesia.
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김경식(Kim, Kyung Sik) ; 김도영(Kim, Do Young) ; 김성훈(Kim, Sung Hoon) ; 이재길(Lee, Jae Gil) ; 최기홍(Choi, Gi Hong) ; 최진섭(Choi, Jin Sub)
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