BACKGROUND AND AIMS: There is no study verifying the predictive value of model for end-stage liver disease and sodium (MELD-Na) for rebleeding and its associated mortality in cirrhotic patients after cessation of acute esophageal variceal hemorrhage (AVH) by endoscopic therapy. This study aimed to determine the predictive value of MELD-Na by comparing with MELD or Child-Turcotte-Pugh (CTP) scores. PATIENTS AND METHODS: Consecutive adult cirrhotic patients after cessation of AVH by endoscopic therapy (endoscopic variceal ligation or sclerotherapy injections) within 48 hours of admission admitted from 2003 to 2012 were analyzed. The clinical characteristics and laboratory data at admission were documented, based on which MELD-Na, MELD, and CTP scores were calculated. RESULTS: Among 429 patients who had complete control of AVH, 97 patients (22.6%) suffered esophageal variceal rebleeding within 3 months and 206 patients (48.0%) within 1 year. Fifty-three patients (12.4%) died within 3 months and 98 patients (22.8%) within 1 year from rebleeding. The area under receiver operator characteristics curve of the MELD-Na score for predicting rebleeding and its associated mortality was significantly higher than that of the MELD and the CTP score (rebleeding: 0.83 vs. 0.77 vs. 0.69 for 3 months and 0.85 vs. 0.80 vs. 0.65 for 1 year, P<0.05; mortality: 0.81 vs. 0.75 vs. 0.66 for 3 months and 0.82 vs. 0.78 vs. 0.68 for 1 year, P<0.05). CONCLUSIONS: The MELD-Na score is clinically useful in predicting 3-month and 1-year rebleeding and its associated mortality in cirrhotic patients after cessation of AVH by endoscopic therapy.
BACKGROUND AND AIMS: There is no study verifying the predictive value of model for end-stage liver disease and sodium (MELD-Na) for rebleeding and its associated mortality in cirrhoticpatients after cessation of acute esophageal variceal hemorrhage (AVH) by endoscopic therapy. This study aimed to determine the predictive value of MELD-Na by comparing with MELD or Child-Turcotte-Pugh (CTP) scores. PATIENTS AND METHODS: Consecutive adult cirrhoticpatients after cessation of AVH by endoscopic therapy (endoscopic variceal ligation or sclerotherapy injections) within 48 hours of admission admitted from 2003 to 2012 were analyzed. The clinical characteristics and laboratory data at admission were documented, based on which MELD-Na, MELD, and CTP scores were calculated. RESULTS: Among 429 patients who had complete control of AVH, 97 patients (22.6%) suffered esophageal variceal rebleeding within 3 months and 206 patients (48.0%) within 1 year. Fifty-three patients (12.4%) died within 3 months and 98 patients (22.8%) within 1 year from rebleeding. The area under receiver operator characteristics curve of the MELD-Na score for predicting rebleeding and its associated mortality was significantly higher than that of the MELD and the CTP score (rebleeding: 0.83 vs. 0.77 vs. 0.69 for 3 months and 0.85 vs. 0.80 vs. 0.65 for 1 year, P<0.05; mortality: 0.81 vs. 0.75 vs. 0.66 for 3 months and 0.82 vs. 0.78 vs. 0.68 for 1 year, P<0.05). CONCLUSIONS: The MELD-Na score is clinically useful in predicting 3-month and 1-year rebleeding and its associated mortality in cirrhoticpatients after cessation of AVH by endoscopic therapy.
Authors: Shivaram P Singh; Manav Wadhawan; Subrat K Acharya; Sawan Bopanna; Kaushal Madan; Manoj K Sahoo; Naresh Bhat; Sri P Misra; Ajay Duseja; Amar Mukund; Anil C Anand; Ashish Goel; Bonthala S Satyaprakash; Joy Varghese; Manas K Panigrahi; Manu Tandan; Mihir K Mohapatra; Pankaj Puri; Pravin M Rathi; Rajkumar P Wadhwa; Sunil Taneja; Varghese Thomas; Vikram Bhatia Journal: Indian J Gastroenterol Date: 2021-12-10
Authors: Jongbeom Shin; Jung Hwan Yu; Young-Joo Jin; Hyung Joon Yim; Young Kul Jung; Jin Mo Yang; Do Seon Song; Young Seok Kim; Sang Gyune Kim; Dong Joon Kim; Ki Tae Suk; Eileen L Yoon; Sang Soo Lee; Chang Wook Kim; Hee Yeon Kim; Jae Young Jang; Soung Won Jeong Journal: Clin Mol Hepatol Date: 2020-09-17