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<p>Impella® (Abiomed, Danvers, MA, USA) is widely used as mechanical circulatory support for cardiogenic shock, yet accurate outcome prediction remains challenging. The Model for End-Stage Liver Disease (MELD) score, derived from routine laboratory parameters, may provide a simple and objective tool for early risk assessment. This study also compared its prognostic performance with that of the Sequential Organ Failure Assessment (SOFA) score. We retrospectively reviewed 119 patients who underwent Impella implantation at a regional tertiary emergency center in Japan between 2020 and 2024. After excluding those who received extracorporeal cardiopulmonary resuscitation or lacked sufficient data, 62 patients were included in the final analysis. A MELD score ≥ 12 and MELD-excluding INR (MELD-XI) score ≥ 15 were significantly associated with 30-day mortality (<i>p</i> = 0.0036 and 0.0003, respectively) and reduced 1-year survival (p = 0.0037 and 0.0024, respectively). Prognostic discrimination of MELD and MELD-XI was comparable to SOFA for short-term outcomes and superior for predicting 1-year survival. MELD-based scores also correlated with SOFA (<i>p</i> &lt; 0.001), indicating shared prognostic relevance. These findings suggest that MELD and MELD-XI are practical and readily accessible tools for both early and long-term risk stratification in patients receiving Impella support. Their simplicity and reliance on routinely available laboratory data may facilitate timely clinical decision-making, including escalation to durable mechanical circulatory support when appropriate.</p>

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Prognostic impact of preoperative liver function on outcomes in patients undergoing Impella® implantation

  • 期刊论文

  • 发表日期：

    2026年3月17日

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  • Toshiyuki Yanai,
  • Tomoko Sugiyama Kato,
  • Takehiro Homma,
  • Maki Otsuka,
  • Tatsuhiro Shibata,
  • Shoichiro Nohara,
  • Yoshihiro Fukumoto

摘要

Impella® (Abiomed, Danvers, MA, USA) is widely used as mechanical circulatory support for cardiogenic shock, yet accurate outcome prediction remains challenging. The Model for End-Stage Liver Disease (MELD) score, derived from routine laboratory parameters, may provide a simple and objective tool for early risk assessment. This study also compared its prognostic performance with that of the Sequential Organ Failure Assessment (SOFA) score. We retrospectively reviewed 119 patients who underwent Impella implantation at a regional tertiary emergency center in Japan between 2020 and 2024. After excluding those who received extracorporeal cardiopulmonary resuscitation or lacked sufficient data, 62 patients were included in the final analysis. A MELD score ≥ 12 and MELD-excluding INR (MELD-XI) score ≥ 15 were significantly associated with 30-day mortality (p = 0.0036 and 0.0003, respectively) and reduced 1-year survival (p = 0.0037 and 0.0024, respectively). Prognostic discrimination of MELD and MELD-XI was comparable to SOFA for short-term outcomes and superior for predicting 1-year survival. MELD-based scores also correlated with SOFA (p < 0.001), indicating shared prognostic relevance. These findings suggest that MELD and MELD-XI are practical and readily accessible tools for both early and long-term risk stratification in patients receiving Impella support. Their simplicity and reliance on routinely available laboratory data may facilitate timely clinical decision-making, including escalation to durable mechanical circulatory support when appropriate.