The Application Value Of MELD-XI Score And FIB-4 Index In Elderly Patients With Chronic Heart Failure

Objective: To investigate the correlation between MELD-XI(Model for end-stage liver disease exclude INR)score and FIB-4 index(Fibrosis-4 index)with different body mass index(BMI)in elderly patients with chronic heart failure(CHF).Methods:A retrospective analysis of 238 patients(134 males and 104 females)with CHF from January 2019 to October 2021 are admitted to the Cardiovascular Department of Hebei Provincial People’s Hospital,according to BMI,the patients are divided into underweight group,normal group,overweight group and obesity group,each group is 12,88,86,52 respectively.The general data,laboratory test,echocardiographic indices,MELD-XI score and FIB-4 Index of each group were compared.Spearman correlation analysis is conducted to analyze the correlation between MELD-XI score,FIB-4 index and other clinical indicators.Multinomial Logistic regression is used to analyze the risk factors of underweight,overweight and obesity groups。Results: 1.There are significant differences in age,BMI,MELD-XI score,FIB-4 index,systolic blood pressure(SBP),diastolic blood pressure(DBP),total cholesterol(TC),triglyceride(TG),platelet(PLT),total bilirubin(TBil),alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transpeptidase(GGT),cholinesterase(Ch E),prealbumin(PAB),right atrium(RA)and right ventricle(RV)among the four groups(P<0.05).The prevalence rates of pulmonary hypertension,hypertension and diabetes are significantly different among the four groups(P < 0.05).2.According to Spearman’s correlation analysis,both MELD-XI score and FIB-4 index are positively correlated with BMI.MELD-XI score is positively correlated with BMI in overweight group(r=0.549,P<0.001)and obesity group(r=0.763,P<0.001),while FIB-4 index is positively correlated with BMI in low weight group(r=0.323,P=0.002).3.Multinomial Logistic regression analysis showed that underweight and overweight had no significant influence factors.MELD-XI score(OR:1.107,P=0.033)and DBP(OR:1.040,P=0.047)are independently associated with obesity in elderly CHF,and are independent risk factors for obesity in elderly CHF.Conclusions:1.MELD-XI score and FIB-4 index were significantly positively correlated with BMI.2.MELD-XI score is significantly positively correlated with BMI of overweight and obesity groups;FIB-4 index is positively correlated with BMI in the underweight group.3.MELD-XI score and DBP are independent risk factors for elderly CHF with obesity.