Author + information
- Arvind Bhimaraj,
- Andrea Cordero-Reyes,
- Hye Yeon Jhun,
- Kassi Mahwash,
- Alejandro Trevino,
- Howard Monsour,
- Catherine Frenette,
- Barry Trachtenberg,
- Guillermo Torre-Amione and
- Jerry Estep
End Stage liver disease patients often have concomitant pulmonary hypertension. The current MELD scoring system does not take into account hemodynamic parameters. The aim of this study was to assess the value of hemodynamic parameters in predicting outcomes
A total of 215 charts of patients with end stage liver disease evaluated for liver transplant were retrospectively reviewed. Cardiovascular profile including right and left heart catheterization at evaluation were retrieved. Primary outcome was death at 1 year and patients were censored for transplant. A total of 195 patients were included in the final analysis. ROC curves were constructed and optimal cutoff values determined, p values <0.05 considered significant.
Mean age at evaluation was 55 ± 10, 63% were male, 47% Caucasian, 17% had DM and 6% with stable CAD. The primary diagnosis in this patient population was Hepatitis C (25%). Mean MELD score was 21.3 ± 8, mean Ejection Fraction was 66 ± 1, mean PA systolic pressure (PASP) was 33± 12 mmHg, mean Cardiac Output 8.2 ± 2.5 L/min. PASP had an AUC of 0.83 cut-off >37 mmHg, sensitivity 84%, specificity 76% with a likelihood ratio of 4.56. The addition of PASP to MELD increased the predictive accuracy of MELD alone. (AUC=0.81).
The hemodynamic assessment in a patient with end-stage liver disease has independent and additive value to the MELD scoring system.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Aortic, Peripheral Vascular and Non-Cardiac Conditions
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1159-113
- 2013 American College of Cardiology Foundation