Molinari et al reports a model for predicting mortality for a cadaveric liver transplant recipient. This can help to identify a patient who may require more aggressive management. The authors are from the University of Pittsburgh, Rutgers University, and the University of Western Ontario.
Patient selection: liver transplant recipient, cadaveric
Parameters:
(1) age of the patient in years
(2) MELD score
(3) body mass index (BMI) in kg per square meter
(4) diabetes mellitus (Type 1 or 2)
(5) pretransplant dialysis
Parameter
Finding
Points
age of the patient
< 65 years
0
65 to 69 years
1
70 to 74 years
2
>= 75 years
3
MELD
< 25
0
25 to 29
1
30 to 34
2
>= 35
3
BMI
< 18.5 kg per sq m
1
18.5 to 39.9
0
>= 40 kg per sq m
1
diabetes mellitus
no
0
yes
1
pretransplant dialysis
no
0
yes
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9, capped at 6 (after which mortality plateaus)
• The higher the score the greater the 90-day postoperative mortality.
Total Score
90-Day Mortality
1-Year Mortality
0
6%
9.8%
1
8.7%
13.4%
2
10.4%
15.8%
3
11.9%
17%
4
15.7%
23%
5
16%
25%
6
19.7%
36%
Performance:
• The area under the ROC curve for all mortality was 0.60.
• The area under the ROC curve to identify risk >= 10% was 0.95.
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