Purpose The Model of End-Stage Liver Disease (MELD) score incorporates measures of kidney and liver dysfunction . MELD score has been shown to predict mortality in patients with advanced heart failure or cardiogenic shock (CS). Prior small single-center studies have shown that MELD score predicts mortality in patients supported with Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO). The Purpose of our was to reassess the role of MELD score predicting Mortality After (VA-ECMO). Methods We reviewed 105 consecutive patients with (CS) who received VA-ECMO between 8/2014 and 6/2018 in our hospital. We calculated MELD, MELD excluding INR (MELDXI), MELD with sodium -MELDNa- (calculated at a mean of 7 hours prior to VA-ECMO initiation), and SAVE score. We identified the association between each score and short-term mortality using logistic regression and Kaplan-Meier with Cox proportional hazard models . Results Our patient had Mean age was 57.1 ± 13.8 years and 32% female. Mean MELD score was 19.5 ± 8.3, MELDXI 18.9 ± 7.1, MELDNa 20.5 ± 8.3, SAVE -8.6 ± 6.5. Inpatient mortality was 68%. SAVE score was associated with short-term (OR 0.91 per 1 unit, 95% CI: 0.84-0.98, P=0.011) and long-term mortality (HR 0.95, 95% CI: 0.91-0.98, P=0.002) (Figure 1). There was no association between MELD (OR 1.02, 95% CI: 0.97-1.08, P=0.41), MELDXI (OR 1.01, 95% CI: 0.95-1.07, P=0.86), or MELDNa (OR 1.02, 95% CI: 0.97-1.08, P=0.41), with inpatient mortality. MELD (OR 1.07, 1.01-1.13, P=0.02), MELDXI (OR 1.12 [1.05-1.20], P=0.001) and MELDNa (OR 1.06, 95% CI: 1.01-1.12, P=0.03) were all associated with need for hemodialysis after ECMO. Conclusion In this single-center study of patients with VA ECMO, neither MELD, nor MELDXI or MELDNa, were associated with short-term or long-term mortality. SAVE score was able to modestly predict inpatient mortality. Further studies are needed to delineate the impact of bystander organ dysfunction to predict mortality in patients supported with VA-ECMO.
