{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:47:28Z","timestamp":1757702848410,"version":"3.37.3"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003The Model for End-stage Liver Disease-Sodium (MELD-Na) score was designed for prognosis of chronic liver disease and has been predictive of outcomes in a variety of procedures. Few studies have investigated its utility in otolaryngology. This study uses the MELD-Na score to investigate the association between liver health and ventral skull base surgical complications.<\/jats:p><jats:p>\n          Methods\u2003The National Surgical Quality Improvement Program database was used to identify patients who underwent ventral skull base procedures between 2005 and 2015. Univariate and multivariate analyses were performed to investigate the association between elevated MELD-Na score and postoperative complications.<\/jats:p><jats:p>\n          Results\u2003We identified 1,077 patients undergoing ventral skull base surgery with laboratory values required to calculate the MELD-Na score. The mean age was 54.2 years. The mean MELD-Na score was 7.70 (standard deviation\u2009=\u20092.04). Univariate analysis showed that elevated MELD-Na score was significantly associated with increased age (58.6 vs 53.8 years) and male gender (70.8 vs 46.1%). Elevated MELD-Na score was associated with increased rates of postoperative acute renal failure, transfusion, septic shock, surgical complications, and extended length of hospital stay. On multivariate analysis, associations between elevated MELD-Na and increased risk of perioperative transfusions (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.20\u20132.93; p\u2009=\u20090.007) and surgical complications (OR, 1.58; 95% CI, 1.25\u20132.35; p\u2009=\u20090.009) remained significant.<\/jats:p><jats:p>\n          Conclusions\u2003This analysis points to an association between liver health and postoperative complications in ventral skull base surgery. Future research investigating this association is warranted.<\/jats:p>","DOI":"10.1055\/a-1842-8668","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T22:53:53Z","timestamp":1651704833000},"page":"405-412","source":"Crossref","is-referenced-by-count":1,"title":["MELD-Na Score as a Predictor of Postoperative Complications in Ventral Skull Base Surgery"],"prefix":"10.1055","volume":"84","author":[{"given":"Liam S.","family":"Flanagan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris B.","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vraj P.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aakash D.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5368-1335","authenticated-orcid":false,"given":"Aksha","family":"Parray","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordon G.","family":"Grube","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina H.","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soly","family":"Baredes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States"},{"name":"Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2893-7818","authenticated-orcid":false,"given":"Jean Anderson","family":"Eloy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States"},{"name":"Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States"},{"name":"Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States"},{"name":"Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, United States"},{"name":"Department of Otolaryngology and Facial Plastic Surgery, Saint Barnabas Medical Center - RWJBarnabas Health, Livingston, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,7,18]]},"reference":[{"volume-title":"Tables of Summary Health Statistics for U.S. Adults: 2018 National Health Interview Survey","year":"2019","author":"M A Villarroel","key":"ref1"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"e201997","DOI":"10.1001\/jamanetworkopen.2020.1997","article-title":"Trends in the burden of chronic liver disease among hospitalized US adults","volume":"3","author":"G Hirode","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.amjsurg.2004.07.034","article-title":"Child-Turcotte-Pugh versus MELD score as a predictor of outcome after elective and emergent surgery in cirrhotic patients","volume":"188","author":"N Farnsworth","year":"2004","journal-title":"Am J Surg"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1016\/j.jhep.2012.03.037","article-title":"Assessment of risk for non-hepatic surgery in cirrhotic patients","volume":"57","author":"P Bhangui","year":"2012","journal-title":"J Hepatol"},{"issue":"07","key":"ref5","doi-asserted-by":"crossref","first-page":"e160789","DOI":"10.1001\/jamasurg.2016.0789","article-title":"Association of model for end-stage liver disease score with mortality in emergency general surgery patients","volume":"151","author":"J M Havens","year":"2016","journal-title":"JAMA Surg"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1002\/lary.26044","article-title":"Liver disease in patients undergoing head and neck surgery: Incidence and risk for postoperative complications","volume":"127","author":"J D Cramer","year":"2017","journal-title":"Laryngoscope"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11605-010-1366-9","article-title":"Perioperative mortality after non-hepatic general surgery in patients with liver cirrhosis: an analysis of 138 operations in the 2000s using Child and MELD scores","volume":"15","author":"H Neeff","year":"2011","journal-title":"J Gastrointest Surg"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1016\/j.mcna.2009.05.008","article-title":"Surgery in the patient with liver disease","volume":"93","author":"D J Muilenburg","year":"2009","journal-title":"Med Clin North Am"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1053\/j.gastro.2007.01.040","article-title":"Risk factors for mortality after surgery in patients with cirrhosis","volume":"132","author":"S H Teh","year":"2007","journal-title":"Gastroenterology"},{"issue":"12","key":"ref10","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1016\/j.oraloncology.2009.07.010","article-title":"The impacts of liver cirrhosis on head and neck cancer patients undergoing microsurgical free tissue transfer: an evaluation of flap outcome and flap-related complications","volume":"45","author":"H K Kao","year":"2009","journal-title":"Oral Oncol"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1002\/hed.21486","article-title":"Predicting postoperative morbidity and mortality by model for endstage liver disease score for patients with head and neck cancer and liver cirrhosis","volume":"33","author":"H-K Kao","year":"2011","journal-title":"Head Neck"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1111\/coa.13500","article-title":"Effect of liver disease on post-therapeutic complications of head and neck squamous cell carcinoma. 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Salamone","year":"2018","journal-title":"World J Emerg Surg"}],"container-title":["Journal of Neurological Surgery Part B: Skull Base"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1842-8668.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T23:17:14Z","timestamp":1688426234000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1842-8668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,4]]},"references-count":37,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2023,7,3]]},"published-print":{"date-parts":[[2023,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1842-8668","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6331","2193-634X"],"issn-type":[{"type":"print","value":"2193-6331"},{"type":"electronic","value":"2193-634X"}],"subject":[],"published-other":{"date-parts":[[2022,5,4]]},"published":{"date-parts":[[2022,5,4]]}}}