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

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 Patie...

Descripción completa

Autores: Bruno, RR; Wernly, B; Hornemann, J; Flaatten, H; Fjolner, J; Artigas, A; Pinto, BB; Schefold, JC; Wolff, G; Baldia, PH; Binneboessel, S; Kelm, M; Beil, M; Sviri, S; van Heerden, PV; Szczeklik, W; Elhadi, M; Joannidis, M; Oeyen, S; Kondili, E; Wollborn, J; Marsh, B; Andersen, FH; Moreno, R; Leaver, S; Boumendil, A; De Lange, DW; Guidet, B; Jung, C
Tipo de documento: Artículo
Estado:Published version
Fecha de publicación:2021
País:España
Institución:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p2121
Acceso en línea:https://i3pt.portalinvestigacion.com/publicaciones/2121
Nivel de acceso:Acceso abierto
Palabra clave:MELD-XI
elderly
intensive care medicine
COVID-19
Sumario: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 1.268-1.949, 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.

Ejemplares similares