Prognostic value of the modified model for end-stage liver disease (MELD) score including albumin in acute heart failure

Abstract Background Liver and renal function evaluated by the model for end-stage liver disease (MELD) score, MELD excluding international normalized ratio (MELD_XI) score including sodium (MELD_sodium) have been considered predictors of adverse events patients with acute heart failure (AHF). However, prognostic value albumin (MELD_albumin) in AHF has not assessed. Methods A total 466 were prospectively evaluated. We compared accuracy 4 formulas using time-dependent receiver operating characteristic (ROC) curve corresponding areas under (AUC). Results During a median follow-up period 34 months, 196 deaths occurred. In fully adjusted Cox regression model, standardized hazard ratios 95% confidence interval expressing risk all-cause mortality 1.22 (1.06–1.40), 1.20 (1.04–1.39), 1.23 (1.06–1.42) 1.21 (1.05–1.41) MELD, MELD_XI, MELD_sodium MELD_albumin scores, respectively. The showed best (AUC = 0.658) prediction long-term mortality, followed 0.590), 0.580), MELD_XI 0.544); performs significantly more accurate than predicting mortality. Considering reclassification, increased net reclassification improvement over beyond (13.1%, P 0.003), (14.8%, 0.002), (11.9%, 0.006) scores Conclusions increases stratification other modified failure.