COMPARATIVE STUDY ON THE PROGNOSTIC VALUE OF MELD, CHILD-PUGH, GLASGOW-BLATCHFORD, ROCKALL, AIMS65, AND ABC SCORES FOR IN-HOSPITAL MORTALITY IN CIRRHOTIC PATIENTS WITH UPPER GASTROINTESTINAL BLEEDING DUE TO ESOPHAGEAL AND GASTRIC VARICEAL RUPTURE

Kỳ Thái Doãn, Bình Mai Thanh, Trang Nguyễn Thị Huyền

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Abstract

Objective: To compare the prognostic value of MELD, Child-Pugh, Glasgow-Blatchford, Rockall, AIMS65, and ABC scores for in-hospital mortality in patients with cirrhosis and upper gastrointestinal bleeding (UGIB) due to esophageal variceal (EV) and gastric variceal (GV) rupture. Methods: A retrospective study was conducted on 201 cirrhotic patients admitted for UGIB at the 108 Military Central Hospital from March 2022 to May 2023. Prognostic scores were derived from available data and evaluated using ROC curves and DeLong’s test. Results: Of 201 patients, 21 (10.4%) died in hospital. Glasgow-Blatchford had the highest AUROC (0.810; 95% CI: 0.701-0.918), followed by ABC (0.804; 95% CI: 0.700-0.908), MELD (0.795; 95% CI: 0.694-0.895), Child-Pugh (0.774; 95% CI: 0.668-0.879), AIMS65 (0.801; 95% CI: 0.663-0.939), and Rockall (0.599; 95% CI: 0.462-0.736). Optimal cutoffs were 14 for Glasgow-Blatchford (sensitivity 52.4%, specificity 89.4%), 8 for ABC (sensitivity 81.0%, specificity 79.4%), 15 for MELD (sensitivity 76.2%, specificity 80.0%), 10 for Child-Pugh (sensitivity 71.4%, specificity 77.8%), 2 for AIMS65 (sensitivity 66.7%, specificity 88.3%), and 5 for Rockall (sensitivity 61.9%, specificity 81.7%). Glasgow-Blatchford outperformed Rockall (p = 0.03) but showed no significant difference with ABC (p = 0.19). Conclusion: Glasgow-Blatchford and ABC are the most effective tools for predicting in-hospital mortality and are suitable for clinical application.

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References

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