MELD-Na score, Acute Physiologic and Chronic Health Evaluation II score, and SOFA score and their association with mortality in critically ill COVID-19 patients with liver injury: A retrospective single-center study.

Q3 Medicine

International Journal of Critical Illness and Injury Science Pub Date : 2022-10-01 Epub Date: 2022-12-26 DOI:10.4103/ijciis.ijciis_29_22

Sandra Gomez-Paz, Eric Lam, Luis Gonzalez-Mosquera, Brian Berookhim, Paul Mustacchia, Joshua Fogel, Sofia Rubinstein

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引用次数: 1

Abstract

Background: The Acute Physiologic and Chronic Health Evaluation II (APACHE-II), Sequential Organ Failure Assessment (SOFA), and Model for End-Stage Liver Disease modified for Sodium concentration (MELD-Na) scores are validated to predict disease mortality. We studied the prognostic utility of these scoring systems in critically ill coronavirus disease 2019 (COVID-19) patients with liver injury.

Methods: This was a retrospective study of 291 confirmed COVID-19 and liver injury patients requiring intensive care unit level of care. These patients required supplemental oxygen requirement with fraction of inspired oxygen >55% and/or the use of vasopressor. MELD-Na, SOFA, and APACHE-II scores were adjusted. Outcomes were mortality and length of stay (LOS).

Results: SOFA (odds ratio: 0.78, 95% confidence interval: 0.63-0.98, P < 0.05) was associated with decreased odds for mortality. APACHE-II and MELD-Na were not associated with mortality or LOS.

Conclusions: We suggest that the novel nature of COVID-19 necessitates new scoring systems to predict outcomes in critically ill COVID-19 patients with liver injury.

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MELD-Na评分、急性生理和慢性健康评估II评分和SOFA评分及其与肝损伤危重新冠肺炎患者死亡率的关系：一项回顾性单中心研究。

背景：急性生理和慢性健康评估II（APACHE-II）、序贯器官衰竭评估（SOFA）和钠浓度修正终末期肝病模型（MELD-Na）评分已被验证可预测疾病死亡率。我们研究了这些评分系统在2019年重症冠状病毒病（新冠肺炎）肝损伤患者中的预后效用。方法：这是对291名需要重症监护室级别护理的确诊新冠肺炎和肝损伤患者的回顾性研究。这些患者需要补充氧气需求，吸入氧气的比例>55%和/或使用血管升压药。对MELD Na、SOFA和APACHE-II评分进行了调整。结果：SOFA（优势比：0.78，95%置信区间：0.63-0.98，P<0.05）与死亡率降低相关。APACHE-II和MELD-Na与死亡率或LOS无关。结论：我们认为新冠肺炎的新性质需要新的评分系统来预测患有肝损伤的新冠肺炎危重患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Critical Illness and Injury Science Medicine-Emergency Medicine

CiteScore

1.40

自引率

0.00%

发文量

期刊介绍： IJCIIS encourages research, education and dissemination of knowledge in the field of Critical Illness and Injury Science across the world thus promoting translational research by striking a synergy between basic science, clinical medicine and public health. The Journal intends to bring together scientists and academicians in the emergency intensive care and promote translational synergy between Laboratory Science, Clinical Medicine and Public Health. The Journal invites Original Articles, Clinical Investigations, Epidemiological Analysis, Data Protocols, Case Reports, Clinical Photographs, review articles and special commentaries. Students, Residents, Academicians, Public Health experts and scientists are all encouraged to be a part of this initiative by contributing, reviewing and promoting scientific works and science.