{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:33:06Z","timestamp":1786116786302,"version":"build-2736575974"},"reference-count":23,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018542","name":"Natural Science Foundation of Sichuan Province","doi-asserted-by":"publisher","award":["2024NSFSC0646"],"award-info":[{"award-number":["2024NSFSC0646"]}],"id":[{"id":"10.13039\/501100018542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Tuberculous constrictive pericarditis (TCP) is characterized by \u201cbackward failure\u201d and systemic venous congestion, leading to secondary multi-organ dysfunction. The Model for End-Stage Liver Disease (MELD) 3.0 score assesses liver, renal, and nutritional status, yet its prognostic utility in TCP remains undefined. This study aimed to evaluate the preoperative MELD 3.0 score as a predictor of time to discharge in patients undergoing pericardiectomy for TCP. Methods: We analyzed 190 patients undergoing pericardiectomy for TCP between 2018 and 2024. The association between preoperative MELD 3.0 scores and time to discharge (ICU, postoperative, and total) was assessed using Fine\u2013Gray competing risks regression to account for in-hospital mortality. Models were adjusted for age, albumin, and anti-tuberculosis therapy. Results: Each unit increase in MELD 3.0 was associated with higher operative mortality (OR 1.21, p = 0.013). In multivariable analysis, a high MELD 3.0 score (&gt;median 9.6) was independently associated with a lower probability of discharge (i.e., delayed discharge) for total hospital stay (subdistribution hazard ratio [sHR] 0.606, 95% CI 0.453\u20130.811), postoperative stay (sHR 0.665), and ICU stay (sHR 0.658). Preoperative albumin was also a strong predictor of faster discharge. Conclusions: The preoperative MELD 3.0 score independently predicts delayed hospital discharge after pericardiectomy for TCP, even when accounting for mortality risk. It serves as a pragmatic tool for quantifying the systemic burden of congestion and stratifying perioperative risk.<\/jats:p>","DOI":"10.3390\/jcm15156118","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T11:43:02Z","timestamp":1786016582000},"page":"6118","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["MELD 3.0 Score and Time to Discharge After Pericardiectomy: A Competing Risks Analysis in Tuberculous Constrictive Pericarditis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1204-544X","authenticated-orcid":false,"given":"Xiaoqiang","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, The Third People\u2019s Hospital of Chengdu, Chengdu 610031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7489-2716","authenticated-orcid":false,"given":"Shuzhen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Third People\u2019s Hospital of Chengdu, Chengdu 610031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5468-6210","authenticated-orcid":false,"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China"},{"name":"Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China"},{"name":"Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9980-2369","authenticated-orcid":false,"given":"Jing","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Third People\u2019s Hospital of Chengdu, Chengdu 610031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5018-1722","authenticated-orcid":false,"given":"Kunyue","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Third People\u2019s Hospital of Chengdu, Chengdu 610031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Third People\u2019s Hospital of Chengdu, Chengdu 610031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0452-9273","authenticated-orcid":false,"given":"Wenqian","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China"},{"name":"Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China"},{"name":"Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4996-6810","authenticated-orcid":false,"given":"Feng","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Third People\u2019s Hospital of Chengdu, Chengdu 610031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"ref_1","first-page":"e18252","article-title":"Pericardiectomy for constrictive tuberculous pericarditis: A systematic review and meta-analysis on the etiology, patients\u2019 characteristics, and the outcomes","volume":"13","author":"Yadav","year":"2021","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s11886-020-1254-1","article-title":"Diagnosis and management of tuberculous pericarditis: What is new?","volume":"22","author":"Isiguzo","year":"2020","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.athoracsur.2012.03.079","article-title":"Contemporary etiologies, risk factors, and outcomes after pericardiectomy","volume":"94","author":"George","year":"2012","journal-title":"Ann. Thorac. Surg."},{"key":"ref_4","first-page":"e110","article-title":"Risk factors for mortality after pericardiectomy for chronic constrictive pericarditis in a large single-centre cohort","volume":"48","author":"Busch","year":"2015","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1186\/s13019-020-01198-9","article-title":"Predictors of postoperative complication and prolonged intensive care unit stay after complete pericardiectomy in tuberculous constrictive pericarditis","volume":"15","author":"Fang","year":"2020","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/j.mayocp.2020.08.048","article-title":"MELD and MELD XI scores as predictors of mortality after pericardiectomy for constrictive pericarditis","volume":"96","author":"Mauermann","year":"2021","journal-title":"Mayo Clin. Proc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jceh.2012.11.002","article-title":"Model for end-stage liver disease","volume":"3","author":"Singal","year":"2013","journal-title":"J. Clin. Exp. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e009020","DOI":"10.1161\/JAHA.118.009020","article-title":"Prognostic value of hepatorenal function by modified model for end-stage liver disease (MELD) score in patients undergoing tricuspid annuloplasty","volume":"7","author":"Chen","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s10047-015-0853-x","article-title":"Model for end-stage liver disease predicts right ventricular failure in patients with left ventricular assist devices","volume":"19","author":"Yost","year":"2016","journal-title":"J. Artif. Organs"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Lin, Z., Liu, X., Xiao, L., Li, Y., Qi, C., Song, S., Zhao, Y., and Zou, L. (2022). The MELD-XI score predicts 3-year mortality in patients with chronic heart failure. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.985503"},{"key":"ref_11","first-page":"699","article-title":"Prognostic value of impaired hepato-renal function assessed by the MELD-XI score in patients undergoing percutaneous mitral valve repair","volume":"93","author":"Spieker","year":"2019","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1053\/j.gastro.2021.08.050","article-title":"MELD 3.0: The model for end-stage liver disease updated for the modern era","volume":"161","author":"Kim","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3608","DOI":"10.1161\/CIRCULATIONAHA.105.543066","article-title":"Tuberculous pericarditis","volume":"112","author":"Mayosi","year":"2005","journal-title":"Circulation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1053\/jhep.2003.50062","article-title":"Cardiac hepatopathy: Clinical, hemodynamic, and histologic characteristics and correlations","volume":"37","author":"Myers","year":"2003","journal-title":"Hepatology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.healun.2012.02.027","article-title":"Liver dysfunction as a predictor of outcomes in patients with advanced heart failure requiring ventricular assist device support: Use of the model of end-stage liver disease (MELD) and MELD excluding INR (MELD-XI) scoring system","volume":"31","author":"Yang","year":"2012","journal-title":"J. Heart Lung Transplant."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1016\/j.athoracsur.2018.12.011","article-title":"Model for end-stage liver disease score independently predicts mortality in cardiac surgery","volume":"107","author":"Hawkins","year":"2019","journal-title":"Ann. Thorac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Dybowska, M., Blasinska, K., Gatarek, J., Klatt, M., Augustynowicz-Kopec, E., Tomkowski, W., and Szturmowicz, M. (2022). Tuberculous pericarditis\u2014Own experiences and recent recommendations. Diagnostics, 12.","DOI":"10.3390\/diagnostics12030619"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1053\/j.gastro.2019.03.021","article-title":"Effects of albumin treatment on systemic and portal hemodynamics and systemic inflammation in patients with decompensated cirrhosis","volume":"157","author":"Fernandez","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/j.clnu.2024.02.018","article-title":"The clinical significance of hypoalbuminaemia","volume":"43","author":"Allison","year":"2024","journal-title":"Clin. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1007\/s10067-024-06918-3","article-title":"Geriatric nutrition risk index: A more powerful index identifying muscle mass loss in patients with rheumatoid arthritis","volume":"43","author":"Pan","year":"2024","journal-title":"Clin. Rheumatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1186\/s40001-025-02925-5","article-title":"Dynamic association of serum albumin changes with inflammation, nutritional status and clinical outcomes: A secondary analysis of a large prospective observational cohort study","volume":"30","author":"Li","year":"2025","journal-title":"Eur. J. Med. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.phrs.2004.10.009","article-title":"Evaluation of patient-related factors associated with causality, preventability, predictability and severity of hepatotoxicity during antituberculosis treatment","volume":"51","author":"Sharifzadeh","year":"2005","journal-title":"Pharmacol. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S71","DOI":"10.1111\/j.1440-1843.2008.01340.x","article-title":"Treatment of tuberculosis in presence of hepatic and renal impairment","volume":"13","author":"Chan","year":"2008","journal-title":"Respirology"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/6118\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T12:00:35Z","timestamp":1786017635000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/6118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":23,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jcm15156118"],"URL":"https:\/\/doi.org\/10.3390\/jcm15156118","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]}}}