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

Wei Ting Chen, Chun Yen Lin, I. shyan Sheen, Chang Wen Huang, Tsung Nan Lin, Chun Jung Lin, Wen Juei Jeng, Chien Hao Huang, Yu Pin Ho*, Cheng Tang Chiu

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

31 Scopus citations

Abstract

AIM: To investigate the outcomes, as well as risk factors for 6-wk mortality, in patients with early rebleeding after endoscopic variceal band ligation (EVL) for esophageal variceal hemorrhage (EVH).METHODS: Among 817 EVL procedures performed for EVH between January 2007 and December 2008, 128 patients with early rebleeding, defined as rebleeding within 6 wk after EVL, were enrolled for analysis. RESULT: The rate of early rebleeding after EVL for acute EVH was 15.6% (128/817). The 5-d, 6-wk, 3-mo, and 6-mo mortality rates were 7.8%, 38.3%, 55.5%, and 58.6%, respectively, in these early rebleeding patients. The use of beta-blockers, occurrence of hypovolemicshock, and higher model for end-stage liver disease (MELD) score at the time of rebleeding were independent predictors for 6-wk mortality. A cut-off value of 21.5 for the MELD score was found with an area under ROC curve of 0.862 (P < 0.001). The sensitivity, specifcity, positive predictive value, and negative predictive value were 77.6%, 81%, 71.7%, and 85.3%, respectively. As for the 6-mo survival rate, patients with a MELD score ≥ 21.5 had a significantly lower survival rate than patients with a MELD score < 21.5 (P < 0.001).CONCLUSION: This study demonstrated that the MELD score is an easy and powerful predictor for 6-wk mortality and outcomes of patients with early rebleeding after EVL for EVH.

Original languageEnglish
Pages (from-to)2120-2125
Number of pages6
JournalWorld Journal of Gastroenterology
Volume17
Issue number16
DOIs
StatePublished - 28 04 2011

Keywords

  • Cirrhosis
  • Es-ophageal variceal hemorrhage
  • Model for end-stage liver disease score
  • Mortality
  • Rebleeding

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