Table of Contents (3 pgs)
2018; Elsevier BV; Volume: 216; Issue: 3 Linguagem: Inglês
10.1016/s0002-9610(18)31110-3
ISSN1879-1883
AutoresKimberly Joseph, Patricia L. Turner, Linda Barry, Carnell Cooper, Omar K. Danner, Samuel Enumah, Awori Hayanga, Iyore James, Bridget A. Oppong, C. Michael Gibson, Ala Stanford, Yalaunda M. Thomas, W Weaver, Mallory Williams, Carlton J. Young, L Britt, Ryan Fransman, Alistair Kent, Elliott R. Haut, A Kar, Joseph V. Sakran, Kent A. Stevens, David T. Efron, Christian Jones, Elizabeth Godfrey, Michael Kueht, Abbas Rana, Samir S. Awad, Susan Smith, Susan Hamblin, Oscar M. Guillamondegui, Oliver L. Gunter, Bradley M. Dennis, Alexandra Briggs, Joaquim M. Havens, Alí Salim, Kenneth Christopher,
ResumoIn order to evaluate what kind of change MELD-Na ("the new MELD") presents compared to MELD as a potential clinical decision-making tool for nontransplant procedures, the outcomes of emergency surgeries in 85 patients with cirrhosis were studied against the new and old MELD scores.Morbidity and mortality were high throughout the study population, but some thresholds associated with increased poor outcomes were identified, at scores of 17 (postoperative complications), 19 (30-day mortality), and 12 (need for post-discharge transitional care).MELD-Na noticeably shifts the population's scored often abstracted clinically as the patient's severity of liver diseased to the right, making patients appear sicker in the MELD-Na era.It is crucial that physicians weigh the significant risks associated with a given MELD-Na score when determining whether to utilize surgical or more conservative management techniques for such patients.
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