The highest rates of postoperative bleeding (13.8%) and, repeat thoracotomy (13.2%) & postoperative pneumonia (17.4%) were seen in Group 3 (threefold increase when compared to Group 1, renal failure requiring dialysis ( N = 235, 2.7% in Group 1 v/s N = 78, 22.9% in Group 3) or requiring high dose catecholamines post-operatively or mechanical circulatory support (IABP/ECLS). To perform a univariate analysis of the data, patients were classified into three groups based on the MELD Score: MELD 20 experienced a 31.2% postoperative mortality, compared to Group 1 (4.6%) and Group 2 (17.5%). We retrospectively examined patient data using the MELD score as a predictor of mortality. Risk stratification, using scores such as EURO Score II or STS Short-Term Risk Calculator for patients undergoing cardiac surgery with cardiopulmonary bypass, ignores the quantitative renal and hepatic function therefore, MELD-Score was applied in these cases. * Indications for assessment by a liver transplant centre include Child–Pugh score ≥ B7, MELD score ≥ 13 or one of the following clinical events: refractory ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, recurrent or chronic hepatic encephalopathy, small hepatocellular carcinoma or severe malnutrition.The outcome of the patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) is also influenced by the renal and hepatic organ functions. Child–Pugh and Model for End-Stage Liver Disease (MELD) scoring systems for predicting prognosis in people with decompensated liver disease Enhanced Liver Fibrosis (ELF) test accurately identifies liver fibrosis in patients with chronic hepatitis C. Hepascore: an accurate validated predictor of liver fibrosis in chronic hepatitis C infection. Performance of the aspartate aminotransferase-to-platelet ratio index for the staging of hepatitis C-related fibrosis: an updated meta-analysis. Guidelines for the screening, care and treatment of persons with hepatitis C infection. EASL-ALEH clinical practice guidelines: non-invasive tests for evaluation of liver disease severity and prognosis.
Note that the performance of Hepascore and APRI for predicting the presence of cirrhosis may be less accurate in people with HIV coinfection than in people with HCV mono-infection (be aware of false positive results due to HIV-induced thrombocytopaenia with APRI, or antiretroviral treatment-related hyperbilirubinaemia with Hepascore). † FIB-4 score < 1.45 has a negative predictive value of 90% for advanced liver fibrosis. These thresholds alone should not be used to diagnose cirrhosis. Patients in whom results exceed these thresholds should be referred for further assessment for the presence of cirrhosis by a specialist with experience in assessing liver disease severity and managing patients with advanced liver disease. * These thresholds have good performance characteristics for excluding the presence of cirrhosis. Patented formula combining age, hyaluronate, MMP-3 and TIMP-1ĪPRI = AST to platelet ratio index AST = aspartate aminotransferase ELF = Enhanced Liver Fibrosis GGT = gamma-glutamyl transferase HIV = human immunodeficiency virus MMP-3 = matrix metalloproteinase-3 TIMP-1 = tissue inhibitor of metalloproteinase-1 ULN = upper limit of normal. Patented formula combining bilirubin, GGT, hyaluronate, α-2-macroglobulin, age and sex Non-invasive serum markers for assessing liver fibrosis stage currently available in AustraliaĪPRI = (AST ÷ AST ULN × 100) ÷ platelet count ( × 10 9/L)įIB-4 = (age × AST ) ÷ (platelet count × √ALT )
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