MELD-XI评分在预测感染性心内膜炎合并脓毒症患者短期死亡率中的应用
HE Yu-ying
LIAO You-wan
LU Ping
GAO Jing
DENG Li-zhi
Department of Geriatric Intensive Medicine,Guang-dong Provincial Geriatrics Institute,Guangdong Provincial Peo-ple's Hospital,Guangdong Academy of Medical Sciences,South-ern Medical University,Guangzhou 510080,China
摘要：Background Renal and liver dysfunction,which are common complications in infectious diseases,are associ-ated with poor clinical outcomes.This study aimed to evaluate the prognostic value of the Model for End-Stage Liv-er Disease Excluding International Normalized Ratio(MELD-XI)score for predicting short-term mortality in pa-tients with infective endocarditis(IE)complicated by sepsis.Methods A total of 496 consecutive IE patients com-plicated with sepsis at Guangdong Provincial People's Hospital were enrolled and divided into three groups accord-ing to the tertiles of MELD-XI score:<7.9(n=164),7.9-14.6(n=168),and>14.6(n=164).Major adverse clinical events(MACE)were composite endpoints that included acute heart failure,renal dialysis,stroke,and death during hospitalization.Multivariate analysis was used to explore the prognostic value of MELD-XI score.Results In-hospital and 6-month mortality were 14.3%and 21.5%,respectively.In-hospital mortality and the incidence of MACE rose significantly with higher MELD-XI scores(mortality:8.5%vs.12.5%vs.14.3%,P=0.002;Incidence of MACE:24.4%vs.31%vs.51.2%,P<0.001).Receiver operating characteristic(ROC)curve analysis showed that the optimal cutoff value of MELD-XI score was 15.7[area under the curve(AUC):0.648,95%CI:0.578-0.718,P<0.001].Multivariate regression analysis revealed that MELD-XI score>15.7 was a significantly indepen-dent risk factor for both in-hospital[adjusted odds ratio(OR):2.27,95%CI:1.28-4.05,P=0.005]and 6-month mor-tality[adjusted hazard ratio(HR):1.69,95%CI:1.13-2.53,P=0.011].Conclusions MELD-XI score>15.7 was independently associated with short-term mortality in IE patients complicated with sepsis,suggesting its potential value as a prognostic biomarker for risk stratification in this population.[S Chin J Cardiol 2025;26(3):164-172]
机标关键词：感染性心内膜炎脓毒症患者死亡率短期死亡meld-xi
论文发表日期：2025-09-30
在线出版日期：2025-11-03（本平台首次上网日期，不代表文献的发表时间）
页数：10( 164-172,188 )
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