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MELD-Na score, Acute Physiologic and Chronic Health Evaluation II score, and SOFA score and their association with mortality in critically ill COVID-19 patients with liver injury: A retrospective single-center study
Sandra Gomez-Paz1, Eric Lam2, Luis Gonzalez-Mosquera2, Brian Berookhim2, Paul Mustacchia1, Joshua Fogel3, Sofia Rubinstein4
1 Department of Internal Medicine, Division of Gastroenterology and Hepatology, Nassau University Medical Center, New York, USA
2 Department of Internal Medicine, Nassau University Medical Center, New York, USA
3 Department of Business Management, Brooklyn College, New York, USA
4 Department of Internal Medicine, Division of Nephrology and Hypertension, Nassau University Medical Center, New York, USA
Correspondence Address:
Dr. Sofia Rubinstein
Department of Internal Medicine, Nassau University Medical Center, Division of Nephrology and Hypertension, 2201 Hempstead Turnpike, Box 49, East Meadow, New York 11554
USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijciis.ijciis_29_22
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Background: The Acute Physiologic and Chronic Health Evaluation II (APACHE-II), Sequential Organ Failure Assessment (SOFA), and Model for End-Stage Liver Disease modified for Sodium concentration (MELD-Na) scores are validated to predict disease mortality. We studied the prognostic utility of these scoring systems in critically ill coronavirus disease 2019 (COVID-19) patients with liver injury.
Methods: This was a retrospective study of 291 confirmed COVID-19 and liver injury patients requiring intensive care unit level of care. These patients required supplemental oxygen requirement with fraction of inspired oxygen >55% and/or the use of vasopressor. MELD-Na, SOFA, and APACHE-II scores were adjusted. Outcomes were mortality and length of stay (LOS).
Results: SOFA (odds ratio: 0.78, 95% confidence interval: 0.63–0.98, P < 0.05) was associated with decreased odds for mortality. APACHE-II and MELD-Na were not associated with mortality or LOS.
Conclusions: We suggest that the novel nature of COVID-19 necessitates new scoring systems to predict outcomes in critically ill COVID-19 patients with liver injury.
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