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. 2014 Jun;11(2):178-81.
doi: 10.5114/kitp.2014.43847. Epub 2014 Jun 29.

The Model for End-Stage Liver Disease (MELD) can predict outcomes in ambulatory patients with advanced heart failure who have been referred for cardiac transplantation evaluation

Bożena Szyguła-Jurkiewicz  1 , Michał Zakliczyński  2 , Mariusz Andrejczuk  2 , Mateusz Mościński  3 , Marian Zembala  2
Affiliations

The Model for End-Stage Liver Disease (MELD) can predict outcomes in ambulatory patients with advanced heart failure who have been referred for cardiac transplantation evaluation

Bożena Szyguła-Jurkiewicz et al. Kardiochir Torakochirurgia Pol. 2014 Jun.

Abstract
in English, Polish

Risk stratification in heart failure (HF) patients is an important element for management. There are several risk stratification models that can be used to predict the prognosis of patients with HF, such as Aaronson's scale, CVM-HF (CardioVascular Medicine Heart Failure), the Seattle Heart Failure Model (SHFM) and the Munich score. These models fail to adequately address the impact of multiorgan dysfunction on prognosis. The classical Model for End-Stage Liver Disease (MELD) score consists of: total bilirubin, INR (international normalized ratio) and creatinine level. There are some modifications of the MELD scale: MELD-XI, which excludes the INR score; the mod-MELD score, in which INR is replaced with albumin levels; and MELD-Na, which consists of the bilirubin and creatinine levels, INR ratio and the sodium level. Therefore, the MELD score systems are markers of multisystem dysfunction (renal, cardiac, hepatic). It is important that they are composed of routinely collected laboratory measures which are easy to use.

W etiologicznie i funkcjonalnie niejednorodnej grupie chorych z niewydolnością serca istotnym elementem postępowania jest stratyfikacja ryzyka. Istnieją liczne modele prognostyczne stosowane do oceny ryzyka u chorych z niewydolnością serca, takie jak: skala Aaronsona, skala CVM-HF (CardioVascular Medicine Heart Failure), skala Seattle (The Seattle Heart Failure Model) i skala Monachium. Wymienione skale nie biorą jednak pod uwagę markerów dysfunkcji wielonarządowej mających istotne znaczenie rokownicze w tej grupie chorych. W skład klasycznej skali MELD (Model for End-stage Liver Disease) wchodzi natomiast stężenie bilirubiny, wskaźnik INR oraz stężenie kreatyniny. Istnieje kilka modyfikacji skali MELD: skala MELD XI, z której wyeliminowano wskaźnik INR, skala mod- MELD, w której wskaźnik INR został zastąpiony przez stężenie albumin, oraz skala MELD-Na, obejmująca stężenie kreatyniny, bilirubiny, sodu i wartość wskaźnika INR. Skale MELD są więc markerami dysfunkcji wielonarządowej (nerkowej, sercowej, wątrobowej). Ich zaletą jest to, że w ich skład wchodzą rutynowo oceniane parametry laboratoryjne.

Keywords: MELD scale; chronic heart failure; prognosis.

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References

    1. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the ESC. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012;33:1787–1847. - PubMed
    1. Stehlik J, Hosenpud JD, Edwards LB, Hertz MI, Mehra MR, International Society for Heart and Lung Transplantation ISHLT International Registry for Heart and Lung Transplantation-into the fourth decade, from strength to strength. J Heart Lung Transplant. 2013;32:941–950. - PubMed
    1. Aaronson KD, Schwartz JS, Chen TM, Wong KL, Goin JE, Mancini DM. Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation. Circulation. 1997;95:2660–2667. - PubMed
    1. Koelling TM, Joseph S, Aaronson KD. Heart failure survival score continues to predict clinical outcomes in patients with heart failure receiving beta-blokers. J Heart Lung Transplant. 2004;23:1414–1422. - PubMed
    1. Senni M, Santilli G, Parella P, De Maria R, Alari G, Berzuini C, Scuri M, Filippi A, Migliori M, Minetti B, Ferrazzi P, Gavazzi A. A novel prognostic index to determine the impact of cardiac conditions and co-morbidities on one-year outcome in patients with heart failure. Am J Cardiol. 2006;98:1076–1082. - PubMed

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