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Background <p>The risk of organ function complications during the perioperative period of cardiac valve surgery is high, and organ function assessment is an important step, in this study, we explore the effect of preoperative MELD scores in patients undergoing cardiac valve surgery.</p> Methods <p>We conducted a retrospective analysis of clinical data sourced from the Informative Surgical Patient dataset for Innovative Research Environment (INSPIRE) database, Receiver operating characteristic (ROC) and Precision-Recall Curve (PRC) curves were used to analyze the correlation between various preoperative MELD score and mortality of cardiac valve surgery. Patients were divided into high and low score groups according to cutoff values, and perioperative clinical data of the two groups were compared.</p> Results <p>A total of 962 patients received 985 operations were included in the study, including 524 males (54.4%). Among operations, 593 underwent aortic valve surgery, 340 mitral valve surgery and 52 tricuspid valve surgery. The overall mortality rate of patients was 32/985 (3.25%), compared with the survival group, the non-survival group had a higher age, lower BMI, higher blood test indicators such as creatinine and bilirubin, as well as higher MELDs score. MELD score has better performance both in the ROC curve (AUC: MELD: 0.858, MELD-Na: 0.849, MELD 3.0: 0.835, MELD-XI: 0.834) and PRC curve (MELD: 0.444, MELD-Na: 0.376, MELD 3.0: 0.332, MELD-XI: 0.308). RCS models showed there were linear correlations between the four MELD scores and the prognostic risk of cardiac valve surgery individually (<i>P</i> &lt; 0.05). The Kaplan–Meier survival curves illustrated a significantly lower 28-day-mortality rate in the low MELD group compared to the high MELD group.</p> Conclusions <p>The preoperative MELD score can serve as a valuable tool for assessing patients’ preoperative condition, offering significant guidance for perioperative management of cardiac valve surgery.</p>

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Effect of preoperative model for end-stage liver disease score in cardiac valve surgery

  • 期刊论文

  • 发表日期：

    2026年2月12日

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  • Wei Zhou,
  • Xiao-bin Liu,
  • Zhen Du,
  • Shao-lin Ma,
  • Feng Zhu

摘要

Background

The risk of organ function complications during the perioperative period of cardiac valve surgery is high, and organ function assessment is an important step, in this study, we explore the effect of preoperative MELD scores in patients undergoing cardiac valve surgery.

Methods

We conducted a retrospective analysis of clinical data sourced from the Informative Surgical Patient dataset for Innovative Research Environment (INSPIRE) database, Receiver operating characteristic (ROC) and Precision-Recall Curve (PRC) curves were used to analyze the correlation between various preoperative MELD score and mortality of cardiac valve surgery. Patients were divided into high and low score groups according to cutoff values, and perioperative clinical data of the two groups were compared.

Results

A total of 962 patients received 985 operations were included in the study, including 524 males (54.4%). Among operations, 593 underwent aortic valve surgery, 340 mitral valve surgery and 52 tricuspid valve surgery. The overall mortality rate of patients was 32/985 (3.25%), compared with the survival group, the non-survival group had a higher age, lower BMI, higher blood test indicators such as creatinine and bilirubin, as well as higher MELDs score. MELD score has better performance both in the ROC curve (AUC: MELD: 0.858, MELD-Na: 0.849, MELD 3.0: 0.835, MELD-XI: 0.834) and PRC curve (MELD: 0.444, MELD-Na: 0.376, MELD 3.0: 0.332, MELD-XI: 0.308). RCS models showed there were linear correlations between the four MELD scores and the prognostic risk of cardiac valve surgery individually (P < 0.05). The Kaplan–Meier survival curves illustrated a significantly lower 28-day-mortality rate in the low MELD group compared to the high MELD group.

Conclusions

The preoperative MELD score can serve as a valuable tool for assessing patients’ preoperative condition, offering significant guidance for perioperative management of cardiac valve surgery.