The model for end-stage liver disease (MELD) predicts early and late outcomes of cardiovascular operations in patients with liver cirrhosis

Abstract

Background: We aimed to evaluate the severity of cirrhosis as a predictor of early and late outcomes after cardiovascular operations.

Methods: We retrospectively reviewed patients who underwent cardiovascular operations in our institute between October 1999 and April 2009. The severity of liver cirrhosis was assessed using the Child-Pugh classification and the Model for End-stage Liver Disease (MELD) score.

Results: Liver cirrhosis was identified in 32 consecutive patients. Averages of Child-Pugh and MELD scores were 7.2 ± 1.9 and 11.5 ± 5.1, respectively: 14 patients were classified as Child-Pugh class A, 14 as class B, and 4 as class C. The MELD score was less than 10 (category 1) in 10 patients, between 10 and 14.9 (category 2) in 14, and 15 or higher (category 3) in 8. The hospital mortality rate was 16% (5 of 32). Hospital mortality increased significantly as the MELD score category increased: category 1, 0%; category 2, 7%; and category 3, 50% (p = 0.005). There was no significant association between hospital mortality and Child-Pugh classification: class A, 7%; class B, 21%; and class C, 0% (p = 0.60). Overall survival was 72% ± 8% at 5 years and 47% ± 13% at 10 years. The survival rate decreased significantly as the MELD score category increased (p = 0.004). No relationship was found between the Child-Pugh classification and long-term survival.

Conclusions: Our results suggest that the MELD score is useful to predict hospital death and long-term survival after cardiac operations for patients with liver cirrhosis.

Keywords: 18.