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2099-12-31
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COMPARISON OF ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION II DEATH RISK, CHILD-PUGH, CHARLSON, AND MODEL FOR END-STAGE LIVER DISEASE INDEXES TO PREDICT EARLY MORTALITY AFTER LIVER TRANSPLANTATION
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Intensive Care Division. Department of Surgery and Anatomy. Ribeirão Preto University of São Paulo. Ribeirão Preto, SP, Brazil
Intensive Care Division. Department of Surgery and Anatomy. Ribeirão Preto University of São Paulo. Ribeirão Preto, SP, Brazil
Intensive Care Division. Department of Surgery and Anatomy. Ribeirão Preto University of São Paulo. Ribeirão Preto, SP, Brazil
Intensive Care Division. Department of Surgery and Anatomy. Ribeirão Preto University of São Paulo. Ribeirão Preto, SP, Brazil
Social Medicine Department. Ribeirão Preto University of São Paulo. Ribeirão Preto, SP, Brazil
Laboratory of Biomarkers. René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil
Special Liver Transplantation Unit. Department of Surgery and Anatomy. Ribeirão Preto University of São Paulo. Ribeirão Preto, SP, Brazil
Intensive Care Division. Department of Surgery and Anatomy. Ribeirão Preto University of São Paulo. Ribeirão Preto, SP, Brazil
Intensive Care Division. Department of Surgery and Anatomy. Ribeirão Preto University of São Paulo. Ribeirão Preto, SP, Brazil
Intensive Care Division. Department of Surgery and Anatomy. Ribeirão Preto University of São Paulo. Ribeirão Preto, SP, Brazil
Social Medicine Department. Ribeirão Preto University of São Paulo. Ribeirão Preto, SP, Brazil
Laboratory of Biomarkers. René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil
Special Liver Transplantation Unit. Department of Surgery and Anatomy. Ribeirão Preto University of São Paulo. Ribeirão Preto, SP, Brazil
Abstract
Objective. This study sought to determine which prognostic index was the most efficient to predict early (1-month) mortality of patients undergoing orthotopic liver transplantation (OLT). Materials and methods. This retrospective study included 63 patients including 49 males and 14 females of overall median age 51.6 +/- 9.7 years who were admitted to the intensive care unit (ICU) of a tertiary hospital. The Acute Physiology and Chronic Health Evaluation II (APACHE II) death risk, Child-Pugh, Charlson, and Model for End-stage Liver Disease (MELD) indices pre-OLT and post-OLT were analyzed by generation of receiver operating characteristic (ROC) curves to determine the area under the ROC curve (AUC), as a predictive factor for each index. The level of significance was set at P < .05. Results. The general 1-month posttransplantation mortality rate of OLT patients was 19% (n = 12 p). The AUC was 0.81 (confidence interval [CI] = 0.66-0.96; sensitivity = 72.5; specificity = 83.3) for APACHE II death risk; 0.74 (CI = 0.57-0.92; sensitivity = 76.5; specificity = 66.7) for MELD post-OLT; 0.70 (CI = 0.54-0.85; sensitivity = 64.7; specificity = 66.7) for Child-Pugh; 0.57 (CI = 0.36-0.78; sensitivity = 74.5; specificity = 50.0) for Charlson; and 0.50 (CI = 0.32-0.69; sensitivity = 98.0; specificity = 16.7) for MELD Pre-OLT. Conclusion. Among the studied indices, the APACHE II death risk scoring system was the most effective to predict early mortality after OLT
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