Early Evaluation of Organ Failure Using MELD-XI in Critically Ill Elderly COVID-19 Patients - Sorbonne Université Access content directly
Journal Articles Clinical Hemorheology and Microcirculation Year : 2021

Early Evaluation of Organ Failure Using MELD-XI in Critically Ill Elderly COVID-19 Patients

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

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.

Dates and versions

hal-03879076 , version 1 (30-11-2022)

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Raphael Romano Bruno, Bernhard Wernly, Johanna Hornemann, Hans Flaatten, Jesper Fjølner, et al.. Early Evaluation of Organ Failure Using MELD-XI in Critically Ill Elderly COVID-19 Patients. Clinical Hemorheology and Microcirculation, 2021, 79 (1), pp.109--120. ⟨10.3233/CH-219202⟩. ⟨hal-03879076⟩
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