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https://www.readbyqxmd.com/read/28614247/meld-score-as-a-predictor-of-mortality-length-of-hospital-stay-and-disease-burden-a-single-center-retrospective-study-in-39-323-inpatients
#1
Jan A Roth, Carl Chrobak, Sabine Schädelin, Balthasar L Hug
The laboratory-based model for end-stage liver disease (MELD) score reflects the function of the kidney, liver, and extrinsic coagulation pathway and might be used as a general prognostic tool for the assessment of patients. We therefore aimed to investigate a potential association of the MELD score with mortality, length of hospital stay (LOS), and disease burden in a general patient population.We performed a retrospective observational study at a tertiary referral center. From January 2012 through December 2013, all consecutive inpatients aged 18 years were eligible for the study; patients with missing MELD parameters on hospital admission and/or treatments influencing the international normalized ratio, that is, novel oral anticoagulants and vitamin K antagonists, were excluded...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28553832/preoperative-phenacetin-metabolism-test-in-the-prediction-of-postoperative-liver-dysfunction-of-patients-with-hepatocellular-carcinoma
#2
Xiaohua Pan, Xiaodong Li, Liqing Cui, Qianwei Wang
BACKGROUND The risk of postoperative liver dysfunction (PLD) in patients with injured livers, such as in hepatocellular carcinoma (HCC), is still not negligible. Phenacetin metabolism test can reflect hepatic functional reserve in patients with chronic hepatic damage. The aim of this study was to assess the ability of phenacetin metabolism test to predict PLD in patients with HCC receiving partial hepatectomy. MATERIAL AND METHODS Forty-nine patients with HCC undergoing partial hepatectomy between 2014 and 2016 were included at Huashan Hospital, Fudan University...
May 29, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28501536/multicenter-external-validation-of-risk-stratification-criteria-for-patients-with-variceal-bleeding
#3
Irene Conejo, Maria Anna Guardascione, Puneeta Tandon, Alba Cachero, Josep Castellote, Juan G Abraldes, Lucio Amitrano, Joan Genescà, Salvador Augustin
BACKGROUND & AIMS: Early placement of a transjugular intrahepatic porto-systemic shunts (TIPS) is considered the treatment of choice for patients with acute variceal bleeding (AVB) and cirrhosis who have a high risk of death (Child-Pugh class B with active bleeding at endoscopy or Child-Pugh class C). It has been proposed that patients of Child-Pugh class B, even with active bleeding, should not be considered high risk. Alternative criteria have been proposed for identification of high-risk patients, such as Child-Pugh class C with plasma level of creatinine of 1 mg/dl or more (ChildC-C1) and a model for end-stage liver disease (MELD) score of 19 or more...
May 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28497523/high-meld-score-does-not-adversely-affect-outcome-of-living-donor-liver-transplantation-experience-in-1000-recipients
#4
S K Yadav, N Saraf, S Sigal, N S Choudhary, S Goja, A Rastogi, P Bhangui, A S Soin
In countries where deceased organ donation is scarce, there is big gap between demand and supply of organs and living donor liver transplantation (LDLT) plays an important role in meeting this unmet need. This study was conducted to analyse the effect of pre-transplant MELD score on outcomes following LDLT. Outcome of 1000 patients who underwent LDLT from July 2010 to March 2015 was analysed retrospectively. Patients were grouped into low MELD <25 and high MELD ≥25 score to compare short term outcomes...
May 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28493164/the-model-for-end-stage-liver-disease-predicts%C3%A2-outcomes-in-patients-undergoing-cholecystectomy
#5
Scott C Dolejs, Joal D Beane, Joshua K Kays, Eugene P Ceppa, Ben L Zarzaur
BACKGROUND: The magnitude of risk for patients undergoing cholecystectomy with high model for end-stage liver disease (MELD) scores is poorly understood. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2013 was used to study patients undergoing cholecystectomy. Patients were excluded if they had choledocholithiasis or preoperative dialysis. Bivariate data analysis was performed and logistic regression modeling was conducted to calculate risk-adjusted 30-day outcomes...
May 10, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28489291/long-term-outcomes-of-early-compared-to-late-onset-choledocho-choledochal-anastomotic-strictures-after-orthotopic-liver-transplantation
#6
S K Satapathy, I Sheikh, B Ali, F Yahya, M Kocak, L Parsa, J D Eason, J M Vanatta, S Nair
BACKGROUND: Endoscopic treatment of anastomotic biliary stricture (ABS) after liver transplantation (LT) has been proven to be effective and safe, but long term outcomes of early compared to late onset ABS have not been studied. The aim of this study is to compare the long-term outcome of early ABS to late ABS. METHODS: Of the 806 adult LT recipients (04/2006-12/2012), 93 patients met the criteria for inclusion, and were grouped into non-ABS (No stenosis on ERCP, n=41), early ABS [stenosis < 90 days after LT, 18 (19...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28483678/inequity-in-organ-allocation-for-patients-awaiting-liver-transplantation-rationale-for-uncapping-the-model-for-end-stage-liver-disease
#7
Mitra K Nadim, Joseph DiNorcia, Lingyun Ji, Susan Groshen, Josh Levitsky, Randall S Sung, W Ray Kim, Kenneth Andreoni, David Mulligan, Yuri S Genyk
BACKGROUND: The goal of organ allocation is to distribute a scarce resource equitably to the sickest patients. In the United States, the Model for End-stage Liver Disease (MELD) is used to allocate livers for transplantation. Patients with greater MELD scores have greater risk of death on the waitlist and are prioritized for liver transplant (LT). The MELD is capped at 40, however, and patients with calculated MELD scores >40 are not prioritized despite increased mortality. METHODS: Using United Network for Organ Sharing data, we identified patients listed for LT from February 2002 through December 2012...
May 5, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28445322/validation-of-prognostic-scores-to-predict-short-term-mortality-in-patients-with-hbv-related-acute-on-chronic-liver-failure-the-clif-c-of-is-superior-to-meld-clif-sofa-and-clif-c-aclf
#8
Ning Li, Chong Huang, Kang-Kang Yu, Qing Lu, Guang-Feng Shi, Jian-Ming Zheng
Acute-on-chronic liver failure (ACLF) in chronic hepatitis B (CHB) patients has a high short-term mortality. Identification of effective models to predict the short-term mortality may enable early intervention and improve patients' prognosis. We aim to assess the performance of the CLIF Consortium Organ Failure score (CLIF-C OFs), CLIF sequential organ failure assessment score (CLIF-SOFAs), CLIF Consortium ACLF score (CLIF-C ACLFs), ACLF grade, and model for end-stage liver disease score (MELDs) in predicting the short-term mortality in CHB patients with ACLF...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28441690/the-postoperative-model-for-end-stage-liver-disease-score-as-a-predictor-of-short-term-outcome-after-transplantation-of-extended-criteria-donor-livers
#9
Tamas Benko, Anja Gallinat, Thomas Minor, Fuat H Saner, Georgios C Sotiropoulos, Andreas Paul, Dieter P Hoyer
BACKGROUND: Recently, the postoperative Model for End stage Liver Disease score (POPMELD) was suggested as a definition of postoperative graft dysfunction and a predictor of outcome after liver transplantation (LT). AIM: The aim of the present study was to validate this concept in the context of extended criteria donor (ECD) organs. PATIENTS AND METHODS: Single-center prospectively collected data (OPAL study/01/11-12/13) of 116 ECD LTs were utilized...
June 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28433216/implications-of-alternative-hepatorenal-prognostic-scoring-systems-in-acute-heart-failure-from-dose-ahf-and-rose-ahf
#10
Justin L Grodin, Dianne Gallup, Kevin J Anstrom, G Michael Felker, Horng H Chen, W H Wilson Tang
Because hepatic dysfunction is common in patients with heart failure (HF), the Model for End-Stage Liver Disease (MELD) may be attractive for risk stratification. Although alternative scores such as the MELD-XI or MELD-Na may be more appropriate in HF populations, the short-term clinical implications of these in patients with acute heart failure (AHF) are unknown. The MELD-XI and MELD-Na were calculated at baseline in 453 patients with AHF in the DOSE-AHF and ROSE-AHF trials. The correlations and associations for each score with cardiorenal biomarkers, short-term end points at 72 hours including worsening renal function and clinical events to 60 days were determined...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28420029/interlobar-artery-resistive-index-predicts-acute-on-chronic-liver-failure-syndrome-in-cirrhotic-patients-with%C3%A2-acute-decompensation
#11
Pablo A Solís-Muñoz, Christopher Willars, Julia Wendon, George Auzinger, Michael A Heneghan, Maria De la Flor-Robledo, José A Solís-Herruzo
Introduction Patients with acutely decompensated (AD) cirrhosis are at risk for developing acute-on-chronic liver failure (ACLF) syndrome. This syndrome is associated with a high short-term mortality rate. The aim of our study was to identify reliable early predictors of developing ACLF in cirrhotic patients with AD. Patients and Methods We assessed 84 cirrhotic patients admitted for AD without ACLF on admission. We performed routine blood testing and detailed ultrasound Doppler studies of systemic arteries and mayor abdominal veins and arteries...
April 18, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28381380/a-good-prognostic-predictor-for-liver-transplantation-recipients-with-benign-end-stage-liver-cirrhosis
#12
Qiang Wei, Rahmeet Singh Nemdharry, Run-Zhou Zhuang, Jie Li, Qi Ling, Jian Wu, Tian Shen, Lin Zhou, Hai-Yang Xie, Min Zhang, Xiao Xu, Shu-Sen Zheng
BACKGROUND: Post-transplant model for predicting mortality (PMPM, calculated as -5.359+1.988Xln (serum creatinine [mg/dL])+1.089Xln (total bilirubin [mg/dL])) score has been proved to be a simple and accurate model for predicting the prognosis after liver transplantation (LT) in a single center study. Here we aim to verify this model in a large cohort of patients. METHODS: A total of 2727 patients undergoing LT with end-stage liver cirrhosis from January 2003 to December 2010 were included in this retrospective study...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28369305/comparing-child-pugh-meld-and-fib-4-to-predict-clinical-outcomes-in-hcv-infected-persons-results-from-erchives
#13
Adeel A Butt, Yanjie Ren, Vincent Lo Re, Tamar Taddei, David Kaplan
Background: Identifying HCV+ persons at high risk of early complications can help prioritize treatment decisions. We conducted this study to compare Child-Turcotte-Pugh (CP), MELD and FIB-4 scores for predicting clinical outcomes and to identify those at low risk of complications. Methods: Within Electronically Retrieved Cohort of HCV-Infected Veterans, we identified HCV+ persons and excluded those with HIV+, HBsAg+, prevalent hepatic decompensation (HD), hepatocellular carcinoma (HCC) and those treated for HCV...
March 22, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28364813/model-for-end-stage-liver-disease-sodium-score-the-evolution-in-the-prioritization-of-liver-transplantation
#14
REVIEW
Victor Ilich Machicao
The adoption of the model of end-stage liver disease (MELD) score as surrogate marker of liver disease severity has been the greatest change in liver allocation. Since its implementation, waiting time has lost significance. The MELD score calculation was later modified to reflect the contribution of hyponatremia in the estimation of mortality risk. However, the MELD score does not capture accurately the risk of mortality of patients with hepatocellular carcinoma (HCC). Therefore the arbitrary assignment of MELD points has been used for HCC patients...
May 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28323622/a-quality-of-life-assessment-and-the-correlation-between-generic-and-disease-specific-questionnaires-scores-in-outpatients-with-chronic-liver-disease-pilot-study
#15
Milica Obradovic, Zoran Gluvic, Nina Petrovic, Milan Obradovic, Ratko Tomasevic, Predrag Dugalic, Esma R Isenovic
INTRODUCTION: Chronic liver diseases (CLD) are important cause of morbidity and mortality in general population. The aim of this study was to analyze potential differences between patients with CLD and healthy control group, and to estimate the severity of CLD by using simple questionnaires: general health questionnaire (GHQ-12) and chronic liver disease questionnaire (CLDQ). METHODS: A cross-sectional pilot study was performed in Zemun Clinical Hospital during years 2014 and 2015...
March 20, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28296656/severity-and-outcome-of-acute-on-chronic-liver-failure-is-dependent-on-the-etiology-of-acute-hepatic-insults-analysis-of-368-patients
#16
Shalimar, Saurabh Kedia, Soumya J Mahapatra, Baibaswata Nayak, Deepak Gunjan, Bhaskar Thakur, Subrat K Acharya
BACKGROUND: Acute-on-chronic liver failure (ACLF) may be precipitated by various hepatic insults. The present study evaluated the outcomes of ACLF with different acute insults. PATIENTS AND METHODS: A total of 368 ACLF patients were included. Data collected included etiologies of acute hepatic insult and underlying chronic liver disease, and organ failure. Model for end-stage liver disease (MELD), chronic liver failure consortium (CLIF)-C ACLF, and acute physiology and chronic health evaluation (APACHE) II scores were calculated...
March 14, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28261822/systematic-review-interferon-free-regimens-for-patients-with-hcv-related-child-c-cirrhosis
#17
REVIEW
M Guarino, F Morisco, M R Valvano, A M Ippolito, M Librandi, N Andriulli, M Greco, A Amoruso, A Iacobellis, G Niro, N Caporaso, A Andriulli
BACKGROUND: It is unclear whether the efficacy and long-term outcome of treating patients with hepatitis C virus (HCV)-positive cirrhosis with the new protease inhibitors will extend to those with Child C cirrhosis. AIM: To assess the effectiveness of the interferon-free regimens in Child C cirrhotic patients with HCV infection. METHODS: A systematic Medline search was conducted to retrieve studies describing the treatment of Child C patients with direct-acting agents...
May 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28224766/thromboelastographic-evaluation-of-coagulation-in-patients-with-liver-disease
#18
Kyung Hwa Shin, In Suk Kim, Hyun Ji Lee, Hyung Hoi Kim, Chulhun L Chang, Young Mi Hong, Ki Tae Yoon, Mong Cho
BACKGROUND: The aims of this study were to investigate the parameters of thromboelastography (TEG) for evaluating coagulopathy and to reveal an association with disease severity and/or transfusion requirement in patients with chronic liver disease (CLD) in a clinical laboratory setting. METHODS: We enrolled two groups of adult patients with cirrhotic (N=123) and non-cirrhotic liver disease (N=52), as well as 84 healthy controls. Reaction time (R), kinetic time (K), α-angle (α), maximal amplitude (MA), and coagulation index (CI) were measured with kaolin-activated citrated blood with the TEG 5000 system (Haemonetics Corporation, USA)...
May 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/28220036/proposal-for-a-new-predictive-model-of-short-term-mortality-after-living-donor-liver-transplantation-due-to-acute-liver-failure
#19
COMPARATIVE STUDY
Hyun Sik Chung, Yu Jung Lee, Yun Sung Jo
BACKGROUND Acute liver failure (ALF) is known to be a rapidly progressive and fatal disease. Various models which could help to estimate the post-transplant outcome for ALF have been developed; however, none of them have been proved to be the definitive predictive model of accuracy. We suggest a new predictive model, and investigated which model has the highest predictive accuracy for the short-term outcome in patients who underwent living donor liver transplantation (LDLT) due to ALF. MATERIAL AND METHODS Data from a total 88 patients were collected retrospectively...
February 21, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28211257/renal-replacement-therapy-in-critically-ill-liver-cirrhotic-patients-outcome-and-clinical-implications
#20
Katharina Staufer, Kevin Roedl, Danijel Kivaranovic, Andreas Drolz, Thomas Horvatits, Susanne Rasoul-Rockenschaub, Christian Zauner, Michael Trauner, Valentin Fuhrmann
BACKGROUND & AIMS: Current guidelines discourage renal replacement therapy (RRT) in critically ill cirrhotics in the lack of liver transplant (LT) options. This study aimed to identify patients who benefit from RRT in the short and long-term. METHODS: Critically ill cirrhotics were included over a time period of 6 years and followed for at least 1 year. CLIF-C ACLF, CLIF-SOFA, SOFA and MELD scores on admission, 24 h prior to RRT, 24 and 48 hours after start of RRT were analysed for their predictive value of ICU-mortality...
June 2017: Liver International: Official Journal of the International Association for the Study of the Liver
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