SO SÁNH GIÁ TRỊ TIÊN LƯỢNG CỦA THANG ĐIỂM MAP(ASH) VÀ CHỈ SỐ MELD Ở BỆNH NHÂN XƠ GAN CÓ XUẤT HUYẾT TIÊU HÓA DO VỠ GIÃN TĨNH MẠCH THỰC QUẢN

Abstract

Objective: Comparison of the prognostic value of 90-day mortality and rebleeding using the MAP(ASH) score and MELD index in cirrhotic patients with gastrointestinal bleeding (GIB) due to esophageal variceal rupture. Methods: A descriptive, prospective study was conducted on 114 cirrhotic patients with GIB caused by esophageal variceal rupture at the Gastroenterology and Hepatology Center, Bach Mai Hospital, from October 2024 to May 2025. MAP(ASH) and MELD scores were assessed within the first 24 hours of admission. Patients were monitored for rebleeding and mortality over 90 days. Results: Both MAP(ASH) and MELD showed good predictive value for mortality, with areas under the ROC curve (AUROC) of 0.842 (95% CI: 0.686 – 0.998; p < 0,001) and 0.869 (95% CI: 0.724 – 1.00; p < 0.001), respectively. For rebleeding, MAP(ASH) and MELD demonstrated fair predictive value, with AUROCs of 0.731 (95% CI: 0.612 – 0.850) and 0.712 (95% CI: 0.589 - 0.835), respectively, both statistically significant (p < 0.001). Conclusion: Both MAP(ASH) and MELD scores have good prognostic value for 90-day mortality and rebleeding in cirrhotic patients with GIB due to esophageal varices. Among them, the MELD score was more valuable in predicting mortality, while the MAP(ASH) score was more useful in predicting rebleeding.