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Validation of prognostic scores for clinical outcomes in cirrhotic patients with acute variceal bleeding

Miguel Motola-Kuba, Angélica Escobedo-Arzate, Félix Téllez-Ávila, José Altamirano, Nancy Aguilar-Olivos, Alberto González-Angulo, Felipe Zamarripa-Dorsey, Misael Uribe, Norberto C. Chávez-Tapia


Background. The Rockall, Glasgow-Blatchford, and AIMS65 are useful and validated scoring systems for predicting the outcomes of patients with nonvariceal gastrointestinal bleeding. However, there are no validated evidence for using them to predict outcomes on variceal bleeding. The aim of this study was to evaluate and compare the prognostic accuracy of different nonvariceal bleeding scores with other liver-specific scoring systems in cirrhotic patients. Material and methods. A retrospective multicenter study that included 160 cirrhotic patients with acute variceal bleeding. The AUROC’s to predict in-hospital mortality, and rebleeding, were analyzed for each scoring system. Results. Overall in-hospital mortality occurred in 13% and in-hospital rebleeding in 12% of patients. The systems with the best AUROC value for predicting mortality were MELD (0.828; 95% CI 0.748-0.909), and AIMS65 (0.817; 95% CI 0.724-0.909). The best score systems for predicting rebleeding were Glasgow-Blatchford (0.756; 95% CI 0.640- 0.827), and Rockall (0.691; 95% CI 0.580-0.802). Conclusions. In addition to liver-specific scores, the AIMS65 score is accurate for predicting in-hospital mortality in cirrhotic patients with acute variceal bleeding. Other scoring systems might be useful for predicting significant clinical outcomes in these patients.

Key words. Prognosis, Cirrhosis, Gastrointestinal hemorrhage, Mortality

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The Official Journal of the Mexican Association of Hepatology, the Latin-American Association for the Study of the Liver and the Canadian Association for the Study of the Liver

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