Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death

Hepatology : Official Journal of the American Association for the Study of Liver Diseases
Douglas M HeumanAnastasios A Mihas

Abstract

Despite the adoption of "sickest first" liver transplantation, pretransplant death remains common, and many early deaths occur despite initially low Model for End-stage Liver Disease (MELD) scores. From 1997-2003, we studied 507 cirrhotic United States veterans referred for consideration of liver transplantation to identify additional predictors of early mortality. Most of the patients were male (98%) with cirrhosis caused by hepatitis C and/or alcohol (88%). Data for 296 patients referred prior to February 27, 2002 (training group), were analyzed; findings were validated in 211 patients referred subsequently (validation group). In the training group, 61 patients (21%) died within 180 days without transplantation; their median initial MELD score was 21. MELD score, persistent ascites, and low serum sodium (<135 meq/L) were independent predictors of early mortality. In patients with a MELD score of less than 21, only low serum sodium and persistent ascites were independent predictors of mortality; for MELD scores above 21, only MELD was independently predictive. Prognostic significance of persistent ascites and low serum sodium for low MELD score patients was confirmed in the validation group. Risk varied continuously with worse...Continue Reading

Citations

Mar 15, 2005·Journal of Hepatology·Evangelos CholongitasAndrew K Burroughs
Apr 9, 2005·Current Opinion in Gastroenterology·Guadalupe Garcia-Tsao
Apr 9, 2005·Current Opinion in Gastroenterology·Kimberly A Brown
Mar 22, 2006·Current Opinion in Gastroenterology·Adnan Said, Michael R Lucey
Apr 7, 2007·Current Opinion in Gastroenterology·Adnan SaidMichael R Lucey
Aug 25, 2006·Journal of Gastroenterology and Hepatology·Jian-Wu YuShu-Chen Li
May 11, 2007·Journal of Gastroenterology and Hepatology·Sachin MathurLindsay D Plank
Aug 14, 2008·Journal of Gastroenterology and Hepatology·Ed Gane
Sep 12, 2009·Journal of Gastroenterology and Hepatology·Jung Min LeeSang Hoon Ahn
Feb 9, 2010·Journal of Gastroenterology and Hepatology·Hui-Chun HuangTeh-Ia Huo
Dec 17, 2009·Journal of Gastroenterology and Hepatology·Darrell H G Crawford, Katherine Stuart
Sep 16, 2011·Journal of Gastroenterology and Hepatology·Florence Wong
Jul 20, 2012·International Journal of Hepatology·Amar Nath MukerjiAshokkumar Jain
Nov 14, 2012·Therapeutic Advances in Endocrinology and Metabolism·Peter Gross
May 16, 2008·Internal Medicine·Peter Gross
Nov 26, 2008·World Journal of Gastroenterology : WJG·Ming JiangXi-Mei Chen
Jun 13, 2009·World Journal of Gastroenterology : WJG·Eduardo Vilar GomezMaria del Rosario Abreu Vazquez
Mar 20, 2010·World Journal of Gastroenterology : WJG·Ming JiangYan-Bing Liu
Jun 3, 2010·World Journal of Gastroenterology : WJG·Yi YangJia-Yin Yang
Oct 14, 2011·International Journal of Hepatology·Kaushal Madan, Ashish Mehta
Mar 5, 2011·Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association·Praveen Sharma, Barjesh C Sharma
Feb 14, 2016·Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi·Wen-Chien FanHan-Chieh Lin
Jun 12, 2013·Journal of the Chinese Medical Association : JCMA·Yun-Hsuan LeeTeh-Ia Huo
Jul 14, 2006·Journal of the Chinese Medical Association : JCMA·Teh-Ia HuoShou-Dong Lee
Nov 26, 2013·The Medical Clinics of North America·Iris W Liou
Oct 15, 2013·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Renata PuglieseJoao Seda Neto
Jan 5, 2011·Mayo Clinic Proceedings·Brianna E VaaVijay H Shah
Dec 7, 2010·Endocrinología y nutrición : órgano de la Sociedad Española de Endocrinología y Nutrición·Mónica Guevara, Pere Ginès
Jul 7, 2009·The Medical Clinics of North America·Juan F Gallegos-Orozco, Hugo E Vargas
Nov 11, 2008·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Frank GrünhageChristoph Reichel
Nov 1, 2006·Gastroentérologie Clinique Et Biologique·Marta Martín-LlahíPere Ginès
May 13, 2008·Gastroenterology·Arun J SanyalVincente Arroyo
Apr 15, 2008·Current Problems in Surgery·Frank J SchabergPeter J Mazzaglia
Mar 15, 2008·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·T-I HuoS-D Lee
Jul 4, 2007·Clinics in Liver Disease·Richard B Freeman
Apr 21, 2007·Journal of Hepatology·Pere Ginès
Jan 31, 2016·Current Opinion in Organ Transplantation·Avash KalraScott W Biggins

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