Table 4:
Multivariable Cox Model Showing the Relationship Between Hepatorenal Function (MELD-XI score) and All-cause Mortality
| Model 1 | HR (95%CI) | p |
|
| ||
| Baseline MELD-XI score, per unit | 1.27 (1.21–1.33) | <0.001 |
| Age, per year | 1.07 (1.03–1.12) | <0.001 |
| Male sex | --- | --- |
| NYHA III/IV | 1.66 (1.47–1.93) | 0.004 |
| Cyanosis | 1.36 (1.08–1.52) | 0.03 |
| Prior palliative surgery | -- | --- |
| Number prior cardiac surgeries | --- | --- |
| *Systemic ventricular dysfunction | 2.84 (1.45–4.11) | <0.001 |
| ≥Moderate systemic AVV regurgitation | --- | --- |
| Diuretics | 1.14 (0.98–1.31) | 0.09 |
| RAAS antagonist | --- | --- |
| Atrial fibrillation | 1.99 (1.17–3.38) | 0.002 |
| Hypertension | --- | --- |
|
| ||
| Model 2 | HR (95%CI) | p |
|
| ||
| Baseline MELD-XI score, per unit | 1.18 (1.06–1.31) | 0.01 |
| Temporal change in MELD-XI, per unit ↑ | 1.24 (1.15–1.36) | 0.004 |
| Age, per year | 1.04 (1.01–1.07) | 0.006 |
| Male sex | --- | --- |
| NYHA III/IV | 1.45 (1.21–1.64) | 0.02 |
| Cyanosis | --- | --- |
| Prior palliative surgery | -- | --- |
| Number prior cardiac surgeries | --- | --- |
| *Systemic ventricular dysfunction | 1.78 (1.19–2.66) | 0.008 |
| ≥Moderate systemic AVV regurgitation | --- | --- |
| Diuretics | --- | --- |
| RAAS antagonist | --- | --- |
| Atrial fibrillation | 2.16 (1.23–3.09) | 0.001 |
| Hypertension | --- | --- |
|
| ||
| Model 3 | HR (95%CI) | p |
|
| ||
| Baseline MELD-XI score, per unit | 1.21 (1.02–1.39) | 0.02 |
| Postop change in MELD-XI, per unit ↓ | 0.94 (0.90–0.98) | 0.008 |
| Age, per year | 1.08 (1.02–1.114) | 0.009 |
| Male sex | --- | --- |
| NYHA III/IV | 1.31 (0.97–2.63) | 0.08 |
| Cyanosis | --- | --- |
| Prior palliative surgery | -- | --- |
| Number prior cardiac surgeries | --- | --- |
| *Systemic ventricular dysfunction | 1.48 (1.15–2.12) | 0.007 |
| ≥Moderate systemic AVV regurgitation | --- | --- |
| Diuretics | --- | --- |
| RAAS antagonist | --- | --- |
| Atrial fibrillation | 1.46 (1.09–2.92) | 0.01 |
| Hypertension | --- | --- |
Model 1 shows the relationship between baseline MELD-XI score and all-cause mortality, and this model was based on the all patients in the study (n=4, 977).
Model 2 shows the relationship between baseline MELD-XI score, temporal change in MELD-XI score and all-cause mortality, and this model was based on the subgroup of patients with serial MELD-XI data (n=3,864).
Model 3 shows the relationship between baseline MELD-XI score, postoperative change in MELD-XI score and all-cause mortality, and this model was based on the subgroup of patients with preoperative and postoperative MELD-XI data (n=1,856).
Note that all models were adjusted for specific congenital heart disease diagnosis by modeling the different congenital heart lesions as categorical variables using coarctation of aorta as the reference group. Systemic ventricular dysfunction was defined global longitudinal strain less negative that −18%
MELD: Model for end-stage liver disease; HR: Hazard ratio; CI: Confidence interval; AVV: atrioventricular valve; RAAS: renin angiotensin aldosterone system; NYH: New York Heart Association