COMPARING THE PREDICTIVE EFFICACY OF MELD AND ALBI SCORES IN LIVER CIRRHOSIS PATIENTS WITH ACUTE UPPER GASTROINTESTINAL BLEEDING.

Q2 Medicine

Arquivos de Gastroenterologia Pub Date : 2025-09-05 eCollection Date: 2025-01-01 DOI:10.1590/S0004-2803.24612024-075

Zahra Shokati Eshkiki, Razieh Khazaei, Abazar Parsi, Ali Akbar Shayesteh

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Abstract

Background: Acute upper gastrointestinal bleeding (AUGIB) is a critical medical emergency and is a common cause of illness and death in individuals with liver cirrhosis.

Objective: The point of this study was to check how well the albumin-to-bilirubin ratio (ALBI) and model for end-stage liver disease (MELD) scores could predict how these patients would do in the future.

Methods: The Imam Khomeini Hospital gastroenterology department conducted a retrospective examination. We admitted 102 patients with AUGIB and liver cirrhosis from April 2021 to September 2023. The study included a full medical history and clinical evaluation upon admission, as well as all laboratory test results throughout the hospital stay. We diagnosed liver cirrhosis using clinical, laboratory, and radiologic data. We diagnosed AUGIB as having hematemesis, melena, or hematochezia. We then tested the ALBI, MELD, and liver and kidney function. Some criteria allow continuous variable comparison, whereas others allow discrete variable comparison. Death during hospitalization and rebleeding were the key outcomes, with one-month mortality assessed. We compared ALBI and MELD before establishing their relationship to mortality and rebleeding.

Results: Of the 102 patients, 68.5% survived. Upon arrival, we noted a markedly elevated prevalence of edema, ascites, and chilly extremities among patients who did not survive. The MELD and ALBI scoring systems effectively forecast in-hospital mortality. The threshold for MELD is 21 (CI: 0.759-0.930, P=0.00), whereas for ALBI it is -2.3 (CI: 0.865-0.950, P=0.01). Neither party could foresee hospitalization or premature rebleeding. The probability of death may be forecasted using the MELD during the first discharge phase (P<0.05).

Conclusion: The MELD and ALBI scores show a suitable ability to predict short-term outcomes and both of them can predict death and rebleeding, as well as 1-month mortality. Nevertheless, we recommend that in individuals with advanced liver cirrhosis, the MELD score is a more accurate prognostic indicator compared to the ALBI score.

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比较meld和albi评分对肝硬化急性上消化道出血的预测效果。

背景：急性上消化道出血（AUGIB）是一种严重的医学紧急情况，是肝硬化患者疾病和死亡的常见原因。目的：本研究的重点是检查白蛋白与胆红素比值（ALBI）和终末期肝病模型（MELD）评分能否预测这些患者未来的表现。方法：对伊玛目霍梅尼医院消化内科进行回顾性检查。从2021年4月至2023年9月，我们收治了102例AUGIB合并肝硬化患者。该研究包括入院时的完整病史和临床评估，以及住院期间的所有实验室检查结果。我们使用临床、实验室和放射学资料诊断肝硬化。我们将AUGIB诊断为呕血、黑黑或便血。然后我们测试了ALBI、MELD和肝肾功能。一些标准允许连续变量比较，而另一些标准允许离散变量比较。住院期间死亡和再出血是主要结局，评估了一个月的死亡率。我们比较了ALBI和MELD，然后确定它们与死亡率和再出血的关系。结果：102例患者中，生存率为68.5%。到达后，我们注意到在没有存活下来的患者中，水肿、腹水和四肢寒冷的发生率明显升高。MELD和ALBI评分系统有效预测院内死亡率。MELD的阈值为21 (CI: 0.759-0.930， P=0.00)，而ALBI的阈值为-2.3 （CI: 0.865-0.950， P=0.01）。双方都无法预见住院治疗或过早再出血。结论：MELD和ALBI评分对短期预后有较好的预测能力，两者均可预测死亡、再出血及1个月死亡率。然而，我们建议在晚期肝硬化患者中，与ALBI评分相比，MELD评分是更准确的预后指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arquivos de Gastroenterologia Medicine-Gastroenterology

CiteScore

2.00

自引率

0.00%

发文量

109

审稿时长

9 weeks

期刊介绍： The journal Arquivos de Gastroenterologia (Archives of Gastroenterology), a quarterly journal, is the Official Publication of the Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia IBEPEGE (Brazilian Institute for Studies and Research in Gastroenterology), Colégio Brasileiro de Cirurgia Digestiva - CBCD (Brazilian College of Digestive Surgery) and of the Sociedade Brasileira de Motilidade Digestiva - SBMD (Brazilian Digestive Motility Society). It is dedicated to the publishing of scientific papers by national and foreign researchers who are in agreement with the aim of the journal as well as with its editorial policies.