Early evaluation of organ failure using MELD-XI in critically ill elderly COVID-19 patients.

Bruno, Raphael Romano; Wernly, Bernhard; Hornemann, Johanna; Flaatten, Hans; FjØlner, Jesper; Artigas, Antonio; Bollen Pinto, Bernardo; Schefold, Joerg C; Wolff, Georg; Baldia, Philipp Heinrich; Binneboessel, Stephan; Kelm, Malte; Beil, Michael; Sviri, Sigal; van Heerden, Peter Vernon; Szczeklik, Wojciech; Elhadi, Muhammed; Joannidis, Michael; Oeyen, Sandra; Kondili, Eumorfia; ... (2021). Early evaluation of organ failure using MELD-XI in critically ill elderly COVID-19 patients. Clinical hemorheology and microcirculation, 79(1), pp. 109-120. IOS Press 10.3233/CH-219202

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PURPOSECritically 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.METHODSThe 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.RESULTSIn 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 1.268-1.949, p < 0.001), ICU-, and 3-month-mortality.CONCLUSIONIn critically ill elderly intensive care patients with COVID-19, the MELD-XI score constitutes a valuable tool for an early outcome prediction.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Schefold, Jörg Christian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1386-0291

Publisher:

IOS Press

Language:

English

Submitter:

Isabelle Arni

Date Deposited:

29 Sep 2021 08:22

Last Modified:

05 Dec 2022 15:53

Publisher DOI:

10.3233/CH-219202

PubMed ID:

34487039

Uncontrolled Keywords:

COVID-19 MELD-XI elderly intensive care medicine

BORIS DOI:

10.48350/159289

URI:

https://boris.unibe.ch/id/eprint/159289

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