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Early evaluation of organ failure using MELD-XI in critically ill elderly COVID-19 patients.
Bruno, Raphael Romano; Wernly, Bernhard; Hornemann, Johanna; Flaatten, Hans; FjØlner, Jesper; Artigas, Antonio; Bollen Pinto, Bernardo; Schefold, Joerg C; Wolff, Georg; Baldia, Philipp Heinrich; Binneboessel, Stephan; Kelm, Malte; Beil, Michael; Sviri, Sigal; van Heerden, Peter Vernon; Szczeklik, Wojciech; Elhadi, Muhammed; Joannidis, Michael; Oeyen, Sandra; Kondili, Eumorfia; Wollborn, Jakob; Marsh, Brian; Andersen, Finn H; Moreno, Rui; Leaver, Susannah; Boumendil, Ariane; De Lange, Dylan W; Guidet, Bertrand; Jung, Christian.
  • Bruno RR; Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
  • Wernly B; Department of Department of Anaesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria.
  • Hornemann J; Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
  • Flaatten H; Department of Clinical Medicine, University of Bergen, Department of Anaestesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
  • FjØlner J; Department of Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
  • Artigas A; Department of Intensive Care Medicine, CIBER Enfermedades Respiratorias, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona, Sabadell, Spain.
  • Bollen Pinto B; Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland.
  • Schefold JC; Department of Intensive Care Medicine, Inselspital, Universitätsspital, University of Bern, Bern, Switzerland.
  • Wolff G; Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
  • Baldia PH; Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
  • Binneboessel S; Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
  • Kelm M; Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
  • Beil M; Department of Medical Intensive Care, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
  • Sviri S; Department of Medical Intensive Care, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
  • van Heerden PV; General Intensive Care Unit, Dept. of Anesthesiology, Critical Care and Pain Medicine, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
  • Szczeklik W; Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland.
  • Elhadi M; Faculty of Medicine, University of Tripoli, Tripoli, Libya.
  • Joannidis M; Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria.
  • Oeyen S; Department of Intensive Care 1K12IC Ghent University Hospital, Ghent, Belgium.
  • Kondili E; Intensive Care Unit, University Hospital of Heraklion, Heraklion, Greece.
  • Wollborn J; Department of Anesthesiolgy, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Marsh B; Mater Misericordiae University Hospital, Dublin, Ireland.
  • Andersen FH; Department of Anaesthesia and Intensive Care, Ålesund Hospital, Ålesund, Norway.
  • Moreno R; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
  • Leaver S; Unidade de Cuidados Intensivos Neurocríticos e Trauma. Hospital de São José, Centro Hospitalar Universitário de Lisboa Central, Faculdade de Ciências Médicas de Lisboa, Nova Médical School, Lisbon, Portugal.
  • Boumendil A; General Intensive care, St George's University Hospitals NHS Foundation Trust, London, UK.
  • De Lange DW; Sorbonne Universités, UPMC Univ Paris, INSERM, UMR S, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe: Épidémiologie Hospitaliére Qualité et Organisation des Soins, Paris, France.
  • Guidet B; Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Antoine, Service De Réanimation Médicale, Paris, France.
  • Jung C; Department of Intensive Care Medicine, University Medical Center, University Utrecht, Utrecht, The Netherlands.
Clin Hemorheol Microcirc ; 79(1): 109-120, 2021.
Article in English | MEDLINE | ID: covidwho-1477773
ABSTRACT
PURPOSECritically ill elderly patients who suffer from Sars-CoV-2 disease are at high risk for organ failure. The modified MELD-XI score has not been evaluated for outcome prediction in these most vulnerable patients.METHODSThe Corona Virus disease (COVID19) in Very Elderly Intensive Care Patients study (COVIP, NCT04321265) prospectively recruited patients on intensive care units (ICU), who were = 70 years. Data were collected from March 2020 to February 2021. The MELD-XI score was calculated using the highest serum bilirubin and creatinine on ICU admission. Univariate and multivariable logistic regression analyses were performed to assess associations between the MELD-XI score and mortality. The primary outcome was 30-day-mortality, the secondary outcomes were ICU- and 3-month-mortality.RESULTSIn total, data from 2,993 patients were analyzed. Most patients had a MELD-XI <12 on admission (76%). The patients with MELD-XI = 12 had a significantly higher 30-day-, ICU- and 3-month-mortality (44%vs 64%, and 42%vs. 59%, and 57%vs. 76%, p < 0.001). After adjustment for multiple confounders, MELD-XI = 12 remained significantly associated with 30-day- (aOR 1.572, CI 1.268-1.949, p < 0.001), ICU-, and 3-month-mortality.CONCLUSIONIn critically ill elderly intensive care patients with COVID-19, the MELD-XI score constitutes a valuable tool for an early outcome prediction.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Illness / COVID-19 Type of study: Experimental Studies / Prognostic study Limits: Aged / Humans Language: English Journal: Clin Hemorheol Microcirc Journal subject: Vascular Diseases / Hematology Year: 2021 Document Type: Article Affiliation country: CH-219202

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Illness / COVID-19 Type of study: Experimental Studies / Prognostic study Limits: Aged / Humans Language: English Journal: Clin Hemorheol Microcirc Journal subject: Vascular Diseases / Hematology Year: 2021 Document Type: Article Affiliation country: CH-219202