The predictive value of MELDNa (model for end-stage liver disease-sodium) and mean platelet volume/platelet count for patients' 30-day mortality after liver transplantation.

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY Clinical and Experimental Hepatology Pub Date : 2022-06-01 Epub Date: 2022-03-31 DOI:10.5114/ceh.2022.114907
Vecihe Bayrak, Mehmet Çağatay Gürkök, Ferhan Demirer Aydemir, Bişar Ergün, Tufan Egeli, Nurcan Şentürk Durukan, Tarkan Ünek, Necati Gökmen
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Abstract

Aim of the study: To investigate the disease-specific score and improve the existing scores to better determine the prognosis of patients after liver transplantation (LT). For this purpose, we evaluated the relationship of prognostic scores with 30-day mortality after LT. In addition, we planned to investigate whether the mean platelet volume/platelet count (MPR) would contribute to score improvement.

Material and methods: A total of 178 adult patients admitted to the intensive care unit after LT in our hospital between 2011 and 2019 were retrospectively analyzed. Model for end-stage liver disease-sodium (MELDNa), Child-Turcotte-Pugh (CTP) score, and MPR values were compared in patients with and without 30-day mortality who underwent LT. Logistic regression analysis was performed to determine the predictive factors for mortality. A model was created with multivariate analysis.

Results: Our study included 135 (75.8%) male and 43 (24.2%) female patients. There was a significant difference in the postLT-MELDNa score in the evaluation between those with and without mortality (p < 0.001). Age, postLT-MELDNa and CTP score were found to be significant in terms of the prediction of 30-day mortality in the univariate analysis (p < 0.05). mean platelet volume (MPV) and MPR were not significant in univariate analysis. Multivariate analysis revealed a model in which age and postLT-MELDNa were significant.

Conclusions: In our study, postLT-MELDNa predicted 30-day mortality and was much more effective in predicting mortality when evaluated with age. The MELDNa score, which is currently used in the prognosis of candidates awaiting LT, may be useful for the prognosis of patients after LT in intensive care units.

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MELDNa(终末期肝病模型-钠)和平均血小板体积/血小板计数对肝移植后患者30天死亡率的预测价值
研究目的:探讨疾病特异性评分,改进现有评分,更好地判断肝移植术后患者的预后。为此,我们评估了预后评分与lt后30天死亡率的关系。此外,我们计划研究平均血小板体积/血小板计数(MPR)是否有助于评分的提高。材料与方法:回顾性分析2011 - 2019年我院肝移植后重症监护病房收治的178例成人患者。比较终末期肝病模型-钠(MELDNa)、child - turcote - pugh (CTP)评分和MPR值,并对接受lt治疗的30天死亡率患者进行Logistic回归分析,以确定死亡率的预测因素。通过多变量分析建立模型。结果:本组患者中男性135例(75.8%),女性43例(24.2%)。lt - meldna评分在有死亡和无死亡的评估中有显著差异(p < 0.001)。单变量分析发现,年龄、lt - meldna和CTP评分在预测30天死亡率方面具有显著性(p < 0.05)。平均血小板体积(MPV)和MPR在单因素分析中无统计学意义。多变量分析揭示了一个模型,其中年龄和lt - meldna是显著的。结论:在我们的研究中,lt - meldna预测30天死亡率,并且当与年龄评估时预测死亡率更有效。MELDNa评分目前用于等待肝移植的候选者的预后,可能对重症监护病房肝移植后患者的预后有用。
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来源期刊
Clinical and Experimental Hepatology
Clinical and Experimental Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
2.80
自引率
0.00%
发文量
32
期刊介绍: Clinical and Experimental Hepatology – quarterly of the Polish Association for Study of Liver – is a scientific and educational, peer-reviewed journal publishing original and review papers describing clinical and basic investigations in the field of hepatology.
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