Early Evaluation of Organ Failure Using MELD-XI in Critically Ill Elderly COVID-19 Patients
Raphael Romano Bruno
(1)
,
Bernhard Wernly
(2)
,
Johanna Hornemann
(1)
,
Hans Flaatten
(3)
,
Jesper Fjølner
(4)
,
Antonio Artigas
(5)
,
Bernardo Bollen Pinto
(6)
,
Joerg C. Schefold
,
Georg Wolff
(1)
,
Philipp Heinrich Baldia
(1)
,
Stephan Binneboessel
(1)
,
Malte Kelm
(1)
,
Michael Beil
(7, 8)
,
Sigal Sviri
(8, 7)
,
Peter Vernon Van Heerden
(8, 7)
,
Wojciech Szczeklik
(9)
,
Muhammed Elhadi
,
Michael Joannidis
(10)
,
Sandra Oeyen
(11)
,
Eumorfia Kondili
,
Jakob Wollborn
,
Brian Marsh
(12)
,
Finn H. Andersen
,
Rui Moreno
(13)
,
Susannah Leaver
(14)
,
Ariane Boumendil
(15, 16)
,
Dylan W. de Lange
,
Bertrand Guidet
(15, 16)
,
Christian Jung
(1)
1
Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf]
2 PMU - Paracelsus Medizinische Privatuniversität = Paracelsus Medical University
3 UiB - University of Bergen
4 Aarhus University Hospital
5 CIBERESP - Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública = Consortium for Biomedical Research of Epidemiology and Public Health
6 Geneva University Hospitals and Geneva University
7 Hadassah Hebrew University Medical Center [Jerusalem]
8 HUJ - The Hebrew University of Jerusalem
9 UJ - Uniwersytet Jagielloński w Krakowie = Jagiellonian University
10 IMU - Innsbruck Medical University = Medizinische Universität Innsbruck
11 Ghent University Hospital
12 The Mater Hospital - Mater Misericordiae University Hospital
13 NMS - NOVA Medical School - Faculdade de Ciências Médicas
14 St George’s University Hospitals
15 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
16 CHU Saint-Antoine [AP-HP]
2 PMU - Paracelsus Medizinische Privatuniversität = Paracelsus Medical University
3 UiB - University of Bergen
4 Aarhus University Hospital
5 CIBERESP - Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública = Consortium for Biomedical Research of Epidemiology and Public Health
6 Geneva University Hospitals and Geneva University
7 Hadassah Hebrew University Medical Center [Jerusalem]
8 HUJ - The Hebrew University of Jerusalem
9 UJ - Uniwersytet Jagielloński w Krakowie = Jagiellonian University
10 IMU - Innsbruck Medical University = Medizinische Universität Innsbruck
11 Ghent University Hospital
12 The Mater Hospital - Mater Misericordiae University Hospital
13 NMS - NOVA Medical School - Faculdade de Ciências Médicas
14 St George’s University Hospitals
15 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
16 CHU Saint-Antoine [AP-HP]
Joerg C. Schefold
- Function : Author
Muhammed Elhadi
- Function : Author
Eumorfia Kondili
- Function : Author
Jakob Wollborn
- Function : Author
Finn H. Andersen
- Function : Author
Dylan W. de Lange
- Function : Author
Bertrand Guidet
- Function : Author
- PersonId : 988017
- IdHAL : bertrand-guidet
- ORCID : 0000-0002-7643-6770
- IdRef : 076134350
Abstract
PURPOSE Critically ill elderly patients who suffer from Sars-CoV-2 disease are at high risk for organ failure. The modified MELD-XI score has not been evaluated for outcome prediction in these most vulnerable patients. METHODS The Corona Virus disease (COVID19) in Very Elderly Intensive Care Patients study (COVIP, NCT04321265) prospectively recruited patients on intensive care units (ICU), who were = 70 years. Data were collected from March 2020 to February 2021. The MELD-XI score was calculated using the highest serum bilirubin and creatinine on ICU admission. Univariate and multivariable logistic regression analyses were performed to assess associations between the MELD-XI score and mortality. The primary outcome was 30-day-mortality, the secondary outcomes were ICU- and 3-month-mortality. RESULTS In total, data from 2,993 patients were analyzed. Most patients had a MELD-XI <12 on admission (76%). The patients with MELD-XI = 12 had a significantly higher 30-day-, ICU- and 3-month-mortality (44%vs 64%, and 42%vs. 59%, and 57%vs. 76%, p < 0.001). After adjustment for multiple confounders, MELD-XI = 12 remained significantly associated with 30-day- (aOR 1.572, CI 1.268\textendash 1.949, p < 0.001), ICU-, and 3-month-mortality. CONCLUSION In critically ill elderly intensive care patients with COVID-19, the MELD-XI score constitutes a valuable tool for an early outcome prediction.