Effect of preoperative model for end-stage liver disease score in cardiac valve surgery

Background The risk of organ function complications during the perioperative period of cardiac valve surgery is high, and organ function assessment is an important step, in this study, we explore the effect of preoperative MELD scores in patients undergoing cardiac valve surgery. Methods We conducted a retrospective analysis of clinical data sourced from the Informative Surgical Patient dataset for Innovative Research Environment (INSPIRE) database, Receiver operating characteristic (ROC) and Precision-Recall Curve (PRC) curves were used to analyze the correlation between various preoperative MELD score and prognosis of cardiac valve surgery. Patients were divided into high and low score groups according to cutoff values, and perioperative clinical data of the two groups were compared. Results A total of 962 patients received 985 operations were included in the study, including 524 males (54.4%). Among operations, 593 underwent aortic valve surgery, 340 mitral valve surgery and 52 tricuspid valve surgery. Significant differences were observed between the deceased and survival groups across the various MELD scores in the box plot, while MELD score has better performance both in the ROC curve (AUC: MELD:0.858, MELD-Na: 0.849, MELD 3.0: 0.835, MELD-XI: 0.834) and PRC curve (MELD: 0.444, MELD-Na: 0.376, MELD 3.0: 0.332, MELD-XI: 0.308). RCS models showed there were linear correlations between the four MELD scores and the prognostic risk of cardiac valve surgery individually (P < 0.05). The Kaplan-Meier survival curves illustrated a significantly lower mortality rate in the low MELD group compared to the high MELD group. Conclusions The preoperative MELD score can serve as a valuable tool for assessing patients' preoperative condition, offering significant guidance for perioperative management of cardiac valve surgery.