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PALBI SCORE VALUE FOR PREDICTING 6-WEEK OUTCOME EVENTS IN CIRRHOSIS PATIENTS WITH UPPER GASTROINTESTINAL HEMORRHAGE DUE TO PORTAL VENOUS HYPERTENSION
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Abstract
Background:Upper gastrointestinal bleeding due to portal hypertension is a common medical emergency in patients with cirrhosis. Stratifying high-risk patient groups is very important to help guide treatment plans and improve disease prognosis. Purpose: Determine sensitivity, specificity, positive predictive value and negative predictive value of PALBI score predicts 6-week mortality and rebleeding in patients with acute variceal bleeding. Method: Prospective cohort study of 171 cirrhosis patients diagnosed with acute variceal bleeding admitted to the department of gastroenterology at Nhân Dân Gia Dinh's Hospital from November 2022 to September 2023. Process data using SPSS 26 and Medcalc software. Results: The incidence of rebleeding and mortality within six weeks was 11.6%, respectively; the incidence of rebleeding was 17.5%. Average PALBI score -1.76 ± 0.45. Patients in the PALBI-1, PALBI-2, PALBI-3 groups account for 3.5%, respectively; 21.1%; 75.4%. In the group of patients who died, there were 29 cases in the PALBI-3 group, accounting for 17%; the PALBI-2 group had 1 issue, accounting for 0.5%, and there were no cases in the PALBI-1 group. In the rebleeding patients group, 17 patients in the PALBI-3 group accounted for 9.9%, and three patients belonged to the PALBI-2 group, accounting for 1.8%. At the cutoff point of -1.82, the PALBI score predicted a 6-week mortality risk with a sensitivity of 93.33%, specificity of 53.9%, positive predictive value of 30.1%, negative predictive value of 97.1%, AUC = 0.80. At cutoff point -1.96, sensitivity 85%, specificity 36.42%, positive predictive value 15%, negative predictive value 94.8%, PALBI score predicts 6-week rebleeding with AUC = 0.534, p= 0.618, 95% CI 0.411-0.658. Conclusion: PALBI score predicts 6-week mortality at a reasonable level, helping to stratify high-risk patients to provide appropriate treatment strategies. However, to expect rebleeding at six weeks, the PALBI score was only poor class and not valuable for clinical practice.
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References
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