Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death
Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death
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DOI：
10.1002/hep.20405
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发表时间：
2004-10-01
期刊：
影响因子：
13.5
通讯作者：
Mihas, AA
中科院分区：
文献类型：
--
作者：
Heuman, DM;Abou-assi, SG;Mihas, AA
尽管采用了“病情最重的第一次”肝移植，移植前死亡仍然很常见，尽管最初终末期肝病模型（MELD）评分较低，但仍发生了许多早期死亡。从1997年到2003年，我们研究了507名考虑肝移植的美国退伍军人，以确定早期死亡率的其他预测因素。大多数患者为男性（98%），患有丙型肝炎和/或酒精（88%）引起的肝硬化。对2002年2月27日之前转诊的296例患者（培训组）的数据进行了分析，并在随后转诊的211例患者（验证组）中验证了结果。在训练组中，61名患者（21%）在没有移植的情况下在180天内死亡;他们的初始MELD评分中位数为21。MELD评分、持续性腹水和低血清钠（
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 (