TY - JOUR
T1 - Early evaluation of organ failure using MELD-XI in critically ill elderly COVID-19 patients
AU - Bruno, Raphael Romano
AU - Wernly, Bernhard
AU - Hornemann, Johanna
AU - Flaatten, Hans
AU - Fjølner, Jesper
AU - Artigas, Antonio
AU - Pinto, Bernardo Bollen
AU - Schefold, Joerg C.
AU - Wolff, Georg
AU - Baldia, Philipp Heinrich
AU - Binneboessel, Stephan
AU - Kelm, Malte
AU - Beil, Michael
AU - Sviri, Sigal
AU - Van Heerden, Peter Vernon
AU - Szczeklik, Wojciech
AU - Elhadi, Muhammed
AU - Joannidis, Michael
AU - Oeyen, Sandra
AU - Kondili, Eumorfia
AU - Wollborn, Jakob
AU - Marsh, Brian
AU - Andersen, Finn H.
AU - Moreno, Rui
AU - Leaver, Susannah
AU - Boumendil, Ariane
AU - De Lange, Dylan W.
AU - Guidet, Bertrand
AU - Jung, Christian
N1 - Publisher Copyright:
© 2021 IOS Press. All rights reserved.
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - COVID-19
KW - Elderly
KW - Intensive care medicine
KW - MELD-XI
UR - http://www.scopus.com/inward/record.url?scp=85117374368&partnerID=8YFLogxK
U2 - 10.3233/CH-219202
DO - 10.3233/CH-219202
M3 - Article
C2 - 34487039
AN - SCOPUS:85117374368
SN - 1386-0291
VL - 79
SP - 109
EP - 120
JO - Clinical Hemorheology and Microcirculation
JF - Clinical Hemorheology and Microcirculation
IS - 1
ER -