Prognostic Value of Modified Model for End-Stage Liver Disease Score in Patients Undergoing Isolated Tricuspid Valve Replacement.

Objective: Though the prognostic value of the model for end-stage liver disease (MELD) score in tricuspid surgery was confirmed, the unstable international normalized ratio (INR) may affect the evaluation effectiveness of the MELD score for isolated tricuspid valve replacement (ITVR). The aim of the study was to assess the prognostic value of modified MELD for ITVR. Methods and Results: A total of 152 patients who underwent ITVR were evaluated. The adverse outcome was defined as in-hospital mortality after surgery. The receiver operating characteristic (ROC) curve analysis demonstrated that a modified MELD score with albumin replacing INR (MELD-albumin) score presented well prognostic value [area under the curve (AUC) = 0.731, p = 0.006] for in-hospital mortality. Through Cox regression and further interval validation, the MELD-albumin score was identified as an independent predictor for in-hospital mortality. The optimal cutoff value of MELD-albumin was identified as 8.58 through maximally selected log-rank statistics. In addition, restricted cubic spline analysis demonstrated the linear inverse relationship between MELD-albumin and hazard ratio (HR) for in-hospital mortality. Kaplan-Meier analysis illustrated that in-hospital mortality was increased significantly in the high MELD-albumin (MELD-albumin ≥8.58) group than in the low MELD-albumin group (MELD-albumin <8.58; p < 0.001). Furthermore, high MELD-albumin was associated with lower body mass index (BMI), the incidence of lower extremities edema and moderate drinking history, and the MELD-albumin score was correlated with the value of aspartate transaminase (AST), alanine transaminase (ALT), and albumin. Furthermore, the incidence of renal failure (p = 0.003) and pulmonary infection (p = 0.042) was increased significantly in the high MELD-albumin group. Conclusion: The MELD-albumin score could provide prognostic value for ITVR. In addition, the MELD-albumin score was useful in risk stratification and patient selection for patients with tricuspid regurgitation (TR) prior to ITVR.

Theoretical investigation on the low-lying electronic states of diatomic magnesium bismuthide including the spin-orbit coupling effect.

High-level ab initio computations have been performed to investigate molecular structures, potential energy curves, vibrational energy levels and spectroscopic constants for twelve Λ-S states of the first four dissociation limits of MgBi. Characterizations of seven Ω states, corresponding to the first and the second Λ-S dissociation limits, have been explored for the first time. The spin-orbit coupling effect is revealed to have introduced a significant impact on the pattern of these electronic states and interactions among them. Our predictions for molecular structures and spectroscopic constants of MgBi are compared with available data of other magnesium-group 18 family species. Regular tendencies of these parameters are clearly exhibited when the group 18 atom is replaced by another one in the group. Information associated with transition dipole moments, Franck-Condon factors, vibrational branching ratios and radiative lifetimes between the Ω states are obtained and their transitional properties are analyzed and discussed. The results and data determined in this work are expected to guide and assist laboratorial detections of MgBi and to extend our understanding for the magnesium-group 18 species.