Including body composition in MELD scores improves mortality prediction among patients awaiting liver transplantation.
Hamaguchi Y., Kaido T., Okumura S., Kobayashi A., Shirai H., Yao S.
Retrospective Study with a reported sample of 173, published in Clin Nutr (2019) — summary generated from the PubMed abstract.
Early human evidence such as case series or small samples is exploring possible benefits.
- Level A · Stronger Clinical Evidence
- Level B · Emerging clinical evidence with positive signals
- Level C · Early human research exploring benefits
- Level D · Scientific groundwork from lab and animal studies
- Emerging · Emerging topic under active research
This page is generated from the PubMed record. The Thai description is an automated summary of bibliographic fields and the abstract, not a full translation, and is not medical advice.
- Study type
- Retrospective Study
- Journal
- Clin Nutr (2019)
- Country
- England
- Reported sample size
- 173
- Source database
- PubMed
- PMID
- 31481263
- DOI
- 10.1016/j.clnu.2019.08.012
Abstract (original English)
The Model for End-stage Liver Diseases (MELD) is widely accepted for prioritizing candidates awaiting liver transplantation (LT). However, MELD scores do not reflect the severity of the nutritional or functional status of patients with cirrhosis. This retrospective study analyzed data from 173 patients who were waitlisted for LT at our institution between April 2006 and December 2016. By including skeletal muscle mass, muscle quality and visceral adiposity evaluated using plain computed tomography imaging in MELD scores, we developed body composition-MELD (BC-MELD), and investigated its impact on the prediction of mortality among patients awaiting LT. The equation generated using Cox regression analysis was as follows: BC-MELD = MELD score + 3.59 × low SMI + 5.42 × high IMAC + 2.06 × high VSR. (IMAC, intramuscular adipose tissue content; SMI, skeletal muscle mass index; VSR, visceral-to-subcutaneous adipose tissue area ratio). The median BC-MELD score was 17.4 and the area under the receiver operating characteristic curve (AUC) revealed a cut-off BC-MELD score of 21.4 (AUC = 0.835, P < 0.001, sensitivity 87.5%, specificity 70.7%). Waitlist mortality in patients with high BC-MELD was significantly higher in all tested cohorts (P < 0.001) and among patients with lower conventional MELD scores (<15) (P < 0.001). The discriminatory power was significantly better for BC-MELD than ME
What this study does not prove
- • This study does not prove SVF is an approved treatment or a replacement for standard care.
- • Without an adequate control group, treatment effects cannot be separated from other factors.
Evidence level
Early human evidence such as case series or small samples is exploring possible benefits.
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