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Liver dysfunction as predictor of prognosis in patients with amyloidosis: utility of the Model for End-stage Liver disease (MELD) scoring system

Overview of attention for article published in Internal and Emergency Medicine, August 2016
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Title
Liver dysfunction as predictor of prognosis in patients with amyloidosis: utility of the Model for End-stage Liver disease (MELD) scoring system
Published in
Internal and Emergency Medicine, August 2016
DOI 10.1007/s11739-016-1500-0
Pubmed ID
Authors

Francesco Cappelli, Samuele Baldasseroni, Franco Bergesio, Valentina Spini, Alessia Fabbri, Paola Angelotti, Elisa Grifoni, Paola Attanà, Francesca Tarantini, Niccolò Marchionni, Alberto Moggi Pignone, Federico Perfetto

Abstract

Amyloidosis prognosis is often related to the onset of heart failure and a worsening that is concomitant with kidney-liver dysfunction; thus the Model for End-stage Liver disease (MELD) may be an ideal instrument to summarize renal-liver function. Our aim has been to test the MELD score as a prognostic tool in amyloidosis. We evaluated 128 patients, 46 with TTR-related amyloidosis and 82 with AL amyloidosis. All patients had a complete clinical and echocardiography evaluation; overall biohumoral assessment included troponin I, NT-proBNP, creatinine, total bilirubin and INR ratio. The study population was dichotomized at the 12 cut-off level of MELD scores; those with MELD score >12 had a lower survival compared to controls in the study cohort (40.7 vs 66.3 %; p = 0.006). Either as a continuous and dichotomized variable, MELD shows its independent prognostic value at multivariable analysis (HR = 1.199, 95 % CI 1.082-1.329; HR = 2.707, 95 % CI 1.075-6.817, respectively). MELD shows a lower prognostic sensitivity/specificity ratio than troponin I and NT-proBNP in the whole study population and AL subgroup, while in TTR patients MELD has a higher sensitivity/specificity ratio compared to troponin and NT-proBNP (ROC analysis-AUC: 0.853 vs 0.726 vs 0.659). MELD is able to predict prognosis in amyloidosis. A MELD score >12 selects a subgroup of patients with a higher risk of death. The predictive accuracy seems to be more evident in TTR patients in whom currently no effective scoring systems have been validated.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 7 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 7 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 2 29%
Other 2 29%
Student > Master 1 14%
Student > Ph. D. Student 1 14%
Professor 1 14%
Other 0 0%
Readers by discipline Count As %
Medicine and Dentistry 4 57%
Nursing and Health Professions 1 14%
Decision Sciences 1 14%
Unspecified 1 14%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 February 2017.
All research outputs
#9,650,550
of 12,572,556 outputs
Outputs from Internal and Emergency Medicine
#251
of 389 outputs
Outputs of similar age
#170,221
of 262,809 outputs
Outputs of similar age from Internal and Emergency Medicine
#18
of 28 outputs
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