Open AccessPrognostic value of MELD‐XI score in patients referring to the emergency department with acute ST elevation myocardial infarction
Author(s) -
Çelik Olgun,
Çiftci Orçun,
Müderrisoğlu İbrahim Haldun
Publication year - 2021
Publication title -
hong kong journal of emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 12
eISSN - 2309-5407
pISSN - 1024-9079
DOI - 10.1177/1024907920904191
Subject(s) - medicine , myocardial infarction , odds ratio , confidence interval , emergency department , ejection fraction , cohort , medical record , retrospective cohort study , cardiology , heart failure , psychiatry
Objective: We aimed to evaluate Model for End‐stage Liver Disease excluding international normalized ratio (MELD‐XI) score for prediction of 30‐day in‐hospital mortality in a cohort of patients with ST elevation myocardial infarction. Methods: The medical records of a total of 256 patients admitted with ST elevation myocardial infarction to the emergency department between January 2015 and January 2019 were retrospectively reviewed. A total of 111 patients were found eligible for the study. MELD‐XI score was analyzed and compared on the basis of survival status. Results: A total of 111 patients with a mean age of 62.5 ± 2.55 years were included in the study. In total, 81% (n = 90) of the patients were male and 19% (n = 21) were female. The mean MELD‐XI score of the patients was 10.1 ± 1.1. A total of 12 patients (12.9%) died within 30 days after hospitalization. The median MELD‐XI score of the patients who died in the hospital was significantly higher than the patients survived (11.0 (10.5–11.6) vs 9.5 (9.4–13.8); p < 0.01). However, Gensini score was not significantly different between the surviving and deceased patients (p > 0.05). MELD‐XI score was significantly correlated to left ventricular ejection fraction (r = −232, p < 0.01), and both parameters and age were significant independent predictors of in‐hospital mortality (odds ratio: 1.73, 95% confidence interval: 1.25–2.39, p < 0.05; odds ratio: 0.89, 95% confidence interval: 0.81–0.99, p < 0.05; and odds ratio: 1.07, 95% confidence interval: 0.99–1.15, p < 0.05, respectively). A MELD‐XI cut‐off point of 10 had a sensitivity of 100% and a specificity of 78.8% for in‐hospital mortality (area under receiver operating characteristics curve: 0.92, 95% confidence interval: 0.87–0.97, p < 0.05). A survival analysis based on a MELD‐XI threshold of 10 revealed that the patients in the high‐MELD‐XI group had a significantly worse in‐hospital survival (log rank test p < 0.001). Conclusion: MELD‐XI score is a useful tool for in‐hospital mortality prediction in patients referring to emergency medicine with acute ST elevation myocardial infarction.