{"doi":"10.1016/j.ijcchd.2021.100182","title":"MELD-XI score is not associated with adverse outcomes in ambulatory adults with a Fontan circulation","abstract":"The Model for End-stage Liver Disease excluding INR (MELD-XI) is commonly used to identify patients with a Fontan circulation at increased risk of adverse events, However, this approach has not been evaluated in unselected ambulatory adults. We enrolled a cohort of 163 outpatients with a Fontan circulation aged ≥18-years in the Boston Adult Congenital Heart Disease Biobank from 2012 to 2018. Survival analysis was performed to assess the relationship between MELD-XI with both all-cause mortality and a composite outcome of mortality or non-elective cardiovascular hospitalization. Mean age was 30.2±9.7 years, and 41.1% were women. Most had a lateral tunnel Fontan (62.6%). MELD-XI score averaged 10.6±2.1 (median = 13). Both creatinine and total bilirubin were ≤1.0 mg/dL in 94/163 (57.7%), translating to the lowest possible score. MELD-XI<11 was present in 123 patients (75.5%), while only 3 (1.8%) had MELD-XI>18. During follow-up of 3.2±2.2 years, the composite outcome occurred in 58 patients (35.6%), with 16 deaths (9.8%). Most deaths (n = 11, 68.8%) and composite outcomes (n = 39, 67.2%) occurred among patients with MELD-XI less than the median. MELD-XI score did not differ between those who did and did not have events (death: 10.8±2.2 vs. 10.6±2.1; p = 0.92; composite outcome: 10.6±2.2 vs. 10.7±2.1, p = 0.45). Likewise, survival analysis did not suggest an association between MELD-XI and either outcome. MELD-XI score does not appear to be associated with risk for adverse outcomes in an unselected cohort of outpatients with a Fontan circulation. Prior findings may reflect conditioning on a clinical referral for laboratory testing.","journal":"International Journal of Cardiology Congenital Heart Disease","year":2021,"id":209872,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9312,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":51234,"name":"Chen Wei","orcid":"0000-0002-6287-8658","position":1,"is_corresponding":false},{"id":797958,"name":"Adam M. Lubert","orcid":"0000-0001-6401-9980","position":2,"is_corresponding":false},{"id":797959,"name":"Fred Wu","orcid":"0000-0002-4580-8199","position":3,"is_corresponding":false},{"id":442423,"name":"Anne Marie Valente","orcid":"0000-0002-8357-694X","position":4,"is_corresponding":false},{"id":361269,"name":"Tarek Alsaied","orcid":"0000-0002-3777-4822","position":5,"is_corresponding":false},{"id":797960,"name":"Gabriele Egidy Assenza","orcid":"0000-0001-6591-002X","position":6,"is_corresponding":false},{"id":798483,"name":"Felicia Eichelbrenner","orcid":null,"position":7,"is_corresponding":false},{"id":738329,"name":"Joseph J. Palermo","orcid":"0000-0001-5962-190X","position":8,"is_corresponding":false},{"id":384362,"name":"Michael J. Landzberg","orcid":null,"position":9,"is_corresponding":false},{"id":797961,"name":"Valeria E. Duarte","orcid":"0000-0001-6616-5412","position":10,"is_corresponding":false},{"id":361914,"name":"Alexander R. Opotowsky","orcid":"0000-0002-6107-2281","position":11,"is_corresponding":false},{"id":797957,"name":"Nael Aldweib","orcid":"0000-0002-2680-5371","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-18T23:52:08.869117Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}