MELD score can predict early mortality in patients with rebleeding after band ligation for variceal bleeding

Chen, Wei‐Ting; Lin, Chun‐Yen; Sheen, I‐Shyan; Huang, Changwen; Lin, Tsung-Nan; Lin, Chun-Jung; Jeng, Wen–Juei; Huang, Chien‐Hao; Ho, Yu‐Pin; Chiu, Cheng‐Tang

doi:10.3748/wjg.v17.i16.2120

Cited by 39 publications

(37 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In univariate analysis clot on varix, serum bilirubin, CTP score and MELD score were predictive indicators of rebleeding within 6 weeks. Independent risk factors that predicts early rebleeding in multivariate analysis were clot on varix (P < 0.0001, OR = 11.6, 95% CI: 2.87 -47.29) and serum bilirubin (P < 0.05, OR = 1.1, 95% CI: 1.02 -1.19), which was consistent with other studies [3] [12] [13] [16] [17]. D'Amico et al [18], demonstrated that active bleeding at endoscopy is only independent predictor of early rebleeding, but not of death, while in our study clot on varix was independent predictor of early rebleeding.…”

Section: Discussionsupporting

confidence: 91%

“…Early rebleeding and mortality rate increase sharply within 6 weeks period then stabilized. Early rebleeding rate in the current study was 25.5%, a similar result reported by Krige et al [12] but it is slightly higher than that in some other studies [3] [13] while it is lower than that in other studies [14] [15].…”

Section: Discussionsupporting

confidence: 86%

“…It causes 70% of all upper gastrointestinal bleeding [3]. Approximately 50% of patients with cirrhosis have esophageal varices.…”

Section: Introductionmentioning

confidence: 99%

“…Bleeding from varices occurs in 30% of patients. The risk of recurrent episodes of variceal hemorrhage increases after the first esophageal variceal hemorrhage [3]. There are several factors that may increase the risk of bleeding.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prediction of Early Rebleeding and Mortality after Acute Esophageal Variceal Hemorrhage among Yemeni Patients in Major Hospitals—Sana’a

Hunaysh¹

2016

OJGas

View full text Add to dashboard Cite

Background and aims: Acute variceal hemorrhage (AVH) is the most serious encountered complication of liver cirrhosis and carries high mortality rate. Several risk factors that predict early rebleeding and mortality have been studied and there is no similar study in our country, so the aim of this study was to identify the risk factors of early rebleeding and mortality after bleeding episode in cirrhotic patients in Yemen. Patients and Method: It was a prospective study of cirrhotic patients with AVH who were admitted to the main public hospitals in Sana'a between April 2014 and March 2015. Demographic information, medical histories, physical examination findings, and laboratory test results were collected. Endoscopic and pharmacologic treatment was performed. The patients were followed up since admission and up to 6 weeks for the occurrence of rebleeding and mortality after the acute attack. Univariate and multivariate analyses were performed to identify independent risk factors for rebleeding and mortality. Survival analysis was estimated using the Kaplan-Meier method. Result: A total of 102 patients were analyzed. 26 patients (25.5%) rebleeded within 6 weeks period. The predictive factors significantly associated with rebleeding within 6 weeks period in univariate analysis were clot on varix at index endo-scope (P < 0.0001), high serum bilirubin (P = 0.02), CTP score (P < 0.05) and MELD score (P < 0.05). Independent risks factors remained in multivariate analysis as significant predictors of early rebleeding were clot on varix (OR: 11.6, CI: 2.87 -47.29, P = 0.001) and high serum bilirubin (>3) (OR: 1.1, CI: 1.02 -1.19, P = 0.01). Sixteen patients died (15.7%) within 6 weeks period. Predictors of mortality with significant difference in univariate analysis were hypovolemic shock (P = 0.001), high WBCs count (P < 0.0001), low serum sodium (P = 0.04), high AST (P < 0.0001), high ALT (P = 0.02), high INR (P < 0.0001), high serum bilirubin (P < 0.0001), low serum albumin (P = 0.005), ascites (P = 0.001), A. Y. Hunaysh 215 CTP score (P < 0.0001) and MELD score (P < 0.0001). By multiple regression analysis high MELD score (≥19) (OR: 1.3, CI: 1.12 -1.41, P < 0.0001) and WBCs over 10.3 × 10 9 /l (OR: 1.2, CI: 1.02 -1.40, P < 0.05) were independent risk factors for mortality within 6 weeks period. Conclusion: Early rebleeding in cirrhotic patients with AVH was associated with clot on varix at endoscope and high serum bilirubin more than 3 mg/dl. Early mortality rate was associated with high MELD score (≥19) and WBCs over 10.3 × 10 9 /l.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 86%

“…It causes 70% of all upper gastrointestinal bleeding [3]. Approximately 50% of patients with cirrhosis have esophageal varices.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prediction of Early Rebleeding and Mortality after Acute Esophageal Variceal Hemorrhage among Yemeni Patients in Major Hospitals—Sana’a

Hunaysh¹

2016

OJGas

View full text Add to dashboard Cite

show abstract

“…117 MELD score is also a powerful predictor for mortality at 6 weeks for patients who develop early rebleeding after endoscopic variceal ligation. 118 Comparison of CTP and MELD scores in predicting outcome of VH have shown discrepant data with similar prediction in one study 119 while CTP to be better predictor compared to MELD in another study. 120 …”

Section: Variceal Bleedingmentioning

confidence: 94%