Preoperative MELD score predicts adverse outcomes following gastrectomy: An ACS NSQIP analysis

Am J Surg. 2022 Jul;224(1 Pt B):501-505. doi: 10.1016/j.amjsurg.2022.01.027. Epub 2022 Jan 25.

Abstract

Background: The Model End-Stage Liver Disease (MELD) has been widely used to predict the mortality and morbidity of various surgical procedures. We aimed to assess the impact of preoperative MELD score on adverse 30-day postoperative outcomes following gastrectomy.

Methods: Patients who underwent elective, non-emergent gastrectomy were identified from the ACS NSQIP 2014-2019 database. Patients were categorized according to a calculated MELD score. The primary outcomes of this study were the 30-day overall complications and major complication rates following gastrectomy.

Results: Compared to MELD <11, patients with MELD ≥11 had significantly higher rates of mortality, any complication, and major complication. MELD score ≥11 was significantly associated with any complication (OR 1.73, p = 0.011) and major complications (1.85, p = 0.014) on multivariate analysis.

Conclusions: MELD score ≥11 was associated with poorer outcomes in patients undergoing gastrectomy compared to lower MELD scores.

Keywords: Gastrectomy; Gastric cancer; Model end liver disease; NSQIP; Surgical oncology.

MeSH terms

  • Elective Surgical Procedures / adverse effects
  • End Stage Liver Disease* / complications
  • Gastrectomy / adverse effects
  • Humans
  • Morbidity
  • Postoperative Complications / etiology
  • Retrospective Studies