MELD-XI Score in Hospitalized Heart Failure Patients with Cardiac Electronic Devices

Authors

  • Orçun Çiftci Başkent University Faculty of Medicine, Department of Cardiology
  • Caşit Olgun Çelik Başkent University Faculty of Medicine
  • Kerem Can Yılmaz Başkent University Faculty of Medicine
  • Emir Karaçağlar Başkent University Faculty of Medicine
  • Burak Sezenöz Gazi University Faculty of Medicine
  • Bülent Özin Başkent University Faculty of Medicine
  • İbrahim Haldun Müderrisoğlu Başkent University Faculty of Medicine

Abstract

Objective: MELD-XI (Model for End-Stage Liver Disease Excluding INR) score predicts mortality in patients with heart failure. Herein, we assessed the role of MELD-XI score in predicting in-hospital mortality among heart failure patients having intracardiac cardioverter defibrillator  (ICD) or cardiac resynchronization therapy with defibrillator backup (CRT-D) who presented with appropriate device shock or acute decompensated heart failure.

Methods: We reviewed the medical records of patients with implantable cardioverter defibrillator or cardiac resynchronization therapy with defibrillator backup admitted to coronary care unit with acute decompensated heart failure or appropriate implantable device shocks between 01 January 2013 and 01 November 2018. MELD-XI score was compared between the deceased and surviving patients. The correlation of MELD-XI score with in-hospital mortality was sought.

Results: There were 106 coronary care unit admissions of 67 patients (52 (77.6%) males and 15 (22.4%) females), who had a mean age of 64.8 (range 19-93) years. Eighty-eight (83.0%) admissions were for acute decompensated heart failure and 18 (17.0%) for appropriate device shock and/or electrical storm. A total of 16 (15.1%) patients died at hospital. The median MELD-XI score of the patients who died at hospital was significantly greater than that of the survivors (11.80 (0.59-28.98) vs 15.24 (9.11-24.64); p<0.05). A binary logistic regression analysis showed that MELD-XI score was a significant independent predictor of in-hospital mortality (X2=1.229 (%95 CI 1.06-1.43); p<0.05).

Conclusion: MELD-XI score successfully predicts in-hospital mortality among patients with ICD or CRT-D admitted with acute decompensated heart failure or appropriate implantable electronic device shocks.

Author Biographies

Orçun Çiftci, Başkent University Faculty of Medicine, Department of Cardiology

Assist. Prof. Dr, Department of Cardiology

Caşit Olgun Çelik, Başkent University Faculty of Medicine

Department of Cardiology, MD

Kerem Can Yılmaz, Başkent University Faculty of Medicine

Department of Cardiology, Assist.Prof.Dr.

Emir Karaçağlar, Başkent University Faculty of Medicine

Department of Cardiology, Assist.Prof.Dr.

Burak Sezenöz, Gazi University Faculty of Medicine

Department of Cardiology, Assist.Prof.Dr

Bülent Özin, Başkent University Faculty of Medicine

Department of Cardiology, Prof.Dr

İbrahim Haldun Müderrisoğlu, Başkent University Faculty of Medicine

Department of Cardiology, Prof.Dr

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21.09.2019

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