Publication Name	World Journal of Hepatology
Manuscript ID	116176
Country	United States

Category	Surgery
Manuscript Type	Retrospective Study
Article Title	In-hospital mortality and dynamic modified end-stage liver disease score after emergency general surgery in cirrhotic patients
Manuscript Source	Unsolicited Manuscript
All Author List	Ashling L Zhang, Nathnael Tessema, Jaclyn Clark, Roumen Vesselinov, Lindsay O’Meara, David T Efron and Mira H Ghneim
Funding Agency and Grant Number
Corresponding Author	Mira H Ghneim, Associate Professor, FACS, MD, Program in Trauma, University of Maryland School of Medicine, R. Adams Cowley Shock Trauma Center, 22 S. Greene Street, Baltimore, MD 21201, United States. mira.ghneim@som.umaryland.edu
Key Words	Emergency general surgery; Cirrhosis; Outcomes; Mortality; Model for end-stage liver disease
Core Tip	For cirrhotic patients requiring emergency general surgery, initial model for end-stage liver disease (MELD) score alone may be insufficient for perioperative risk assessment, as MELD can change postoperatively. In this single-center retrospective study of 94 patients, MELD at discharge/death was independently associated with in-hospital mortality, whereas admission and day-of-surgery MELD were not. Among 24 patients whose MELD improved after surgery, 92% survived; among 14 whose MELD worsened, 93% died. All patients with final MELD ≥ 30 died. Increases in MELD were primarily driven by bilirubin and creatinine, highlighting the need for targeted post-operative strategies to limit renal and hepatic dysfunction.
Citation	Zhang AL, Tessema N, Clark J, Vesselinov R, O’Meara L, Efron DT, Ghneim MH. In-hospital mortality and dynamic modified end-stage liver disease score after emergency general surgery in cirrhotic patients. World J Hepatol 2026; In press

Received	2025-11-05 07:17
Peer-Review Started	2025-11-05 07:17
First Decision by Editorial Office Director	2025-11-25 07:54
Return for Revision	2025-11-25 07:54
Revised	2025-12-09 00:08
Publication Fee Transferred
Second Decision by Editor	2026-01-20 02:33
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-01-20 08:29
Articles in Press	2026-01-20 08:29
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5182 (online)
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