comparison of prognosis in patients with liver cirrhosis and its correlation with the model for the end-stage liver disease and child-pugh scores in patients with esophageal or gastric variceal bleeding

نویسندگان

seyedeh masoumeh pashai student research committee, school of medicine, mashhad university of medical sciences, mashhad

mohsen ebrahimi department of emergency medicine, imam reza hospital, mashhad university of medical sciences, mashhad

mohammad reza sheikhian department of internal medicine, imam reza hospital, mashhad university of medical sciences, mashhad

چکیده

background variceal bleeding is one of the most serious complications of cirrhosis. up to now different methods are created for predicting the complications and mortality of cirrhosis. child- pugh score and meld score are two methods for this use. in this study we investigated and compared survival prognosis of cirrhotic patients by the child-pugh or meld score in two groups of esophageal and gastric variceal bleeding. materials and methods in this cross-sectional trial, patients with upper gi bleeding were followed up for a 6 months period. the source of hemorrhage was determined by endoscopy, then patients distributed in two groups of esophageal and gastric variceal hemorrhage. finally we investigated and compared the relationship between the variables and mortality rates in these two groups by means of the child-pugh and the meld scores. the student's t-test and receiver operating characteristic were used for statistical analysis. results 34 patients (12 with gastric varices, 22 with esophageal varices) were investigated. no significant difference between these two groups was observed. in this study mean meld score was 16.67±8.75 and mean child-pugh score was 9.37±2.54. eight patients (5 with gastric varices and 3 with esophageal varices) expired before 6 weeks and 2 patients (one four each group) expired after 6 weeks. the best cut-off points are 15.5 and 10.5 for meld and child-pugh scores respectively (sensitivity and specificity are 0.75 and 0.98, respectively for both scores). conclusion sensitivity and specificity of both scores were the same in prediction of mortality. however, the chance ratio defined that child-pugh score was a better predictor of mortality than meld score, since the chance of death will increase 2.51 and 1.62 fold per each unit increase in the child-pugh and the meld scores, respectively. however, no significant difference found between child-pugh and meld score between two groups of patients.

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re-bleeding in patients with cirrhosis: evaluation of esophageal and gastric variceal bleeding and their relationship with a model for the end-stage liver disease (meld) score and child-pugh score

conclusions the level of two cp and meld scores and their individual variables in two groups of patients with esophageal and gastric varices bleeding were not significantly different. on the other hand, re-bleeding rate was not different between these two groups. results among 34 understudied patients, 12 patients (8 males) had gastric varices and 22 patients (15 males) had esophageal varices. ...

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عنوان ژورنال:
galen medical journal

جلد ۲، شماره ۳، صفحات ۱۰۶-۱۱۳

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