PDF(Pubmed)
Abstract：
The model for end-stage liver disease (MELD) and the model for end-stage liver disease excluding international normalized ratio (INR) (MELD-XI) scores, which reflect dysfunction of liver and kidneys, have been reported to be related to the prognosis of patients with right-sided \"backward\" failure. However, the relationship between the MELD/MELD-XI score and the in-hospital adverse events in pulmonary embolism (PE) patients was unknown. Normotensive PE patients were retrospectively enrolled at China-Japan friendship hospital from January 2017 to February 2020. The primary outcome was defined as death and clinical deterioration during hospitalization. Multivariate logistic analysis was used to explore the association between the MELD and MELD-XI scores for in-hospital adverse events. We also compared the accuracy of the MELD, MELD-XI, and the pulmonary embolism severity index (PESI) score using the time-dependent receiver operating characteristic curve and corresponding areas under the curve (AUC). A total of 222 PE patients were analyzed. Logistic regression analysis showed that the MELD score was independently associated with in-hospital adverse events (odds ratio = 1.115, 95% confidential interval = 1.022-1.217, P = .014). The MELD score has an AUC of 0.731 and was better than PESI (AUC of 0.629) in predicting in-hospital adverse events. Among PE patients with normal blood pressure on admission, the MELD score was associated with increased in-hospital adverse events.
摘要：
终末期肝病模型（MELD）和不包括国际标准化比率（INR）（MELD-XI）评分的终末期肝病模型，这反映了肝脏和肾脏的功能障碍，据报道，与右侧“后向”失败患者的预后有关。然而,MELD/MELD-XI评分与肺栓塞(PE)患者院内不良事件之间的关系未知.回顾性分析2017年1月至2020年2月在中日友好医院就诊的正常血压PE患者。主要结局定义为住院期间死亡和临床恶化。采用多因素Logistic分析探讨MELD和MELD-XI评分与院内不良事件的相关性。我们还比较了MELD的准确性，MELD-XI,和使用时间依赖性受试者工作特征曲线和相应曲线下面积（AUC）的肺栓塞严重程度指数（PESI）评分。对222例PE患者进行了分析。Logistic回归分析显示,MELD评分与院内不良事件独立相关(比值比=1.115,95%保密区间=1.022~1.217,P=0.014)。MELD评分的AUC为0.731，在预测院内不良事件方面优于PESI（AUC为0.629）。在入院时血压正常的PE患者中，MELD评分与院内不良事件增加相关.
