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MELD score can predict early mortality in patients with rebleeding after band ligation for variceal bleeding

查看全文 作　　者：Chun-Yen [1]Lin;I-Shyan [1]Sheen;Tsung-Nan [1]Lin;Chun-Jung [1]Lin;Wen-Juei [1]Jeng;Chien-Hao [1]Huang;Yu-Pin [1]Ho;Cheng-Tang [1]Chiu 高影响力作者 机构地区：[1]Department of Hepato-Gastroenterology,Linkou Medical Center,Chang Gung Memorial Hospital and Chang Gung University College of Medicine高影响力机构 出　　处：《World Journal of Gastroenterology》索引2011年第17卷第16期,共6页高影响力期刊 摘　　要：AIM:To investigate the outcomes,as well as risk factors for 6-wk mortality,in patients with early rebleeding after endoscopic variceal band ligation (EVL) for esophageal variceal hemorrhage (EVH).METHODS:Among 817 EVL procedures performed for EVH between January 2007 and December 2008,128 patients with early rebleeding,defined as rebleeding within 6 wk after EVL,were enrolled for analysis.RESULT:The rate of early rebleeding after EVL for acute EVH was 15.6% (128/817).The 5-d,6-wk,3-mo,and 6-mo mortality rates were 7.8%,38.3%,55.5%,and 58.6%,respectively,in these early rebleeding patients.The use of beta-blockers,occurrence of hypovolemic shock,and higher model for end-stage liver disease (MELD) score at the time of rebleeding were independent predictors for 6-wk mortality.A cut-off value of 21.5 for the MELD score was found with an area under ROC curve of 0.862 (P < 0.001).The sensitivity,specificity,positive predictive value,and negative predictive value were 77.6%,81%,71.7%,and 85.3%,respectively.As for the 6-mo survival rate,patients with a MELD score ≥ 21.5 had a significantly lower survival rate than patients with a MELD score < 21.5 (P < 0.001).CONCLUSION:This study demonstrated that the MELD score is an easy and powerful predictor for 6-wk mortality and outcomes of patients with early rebleeding after EVL for EVH. 关 键 词：早期死亡率 静脉曲张 预测值 出血 患者 评分 破裂 ROC曲线
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