ISSN: 1859 - 2872
Comparison the value of MAP(ASH) score with Child-Pugh and MELD in prognosis of variceal bleeding in cirrhosis patients
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Abstract
Objective: To compare the value of MAP(ASH) score with Child-Pugh (CP) and model of end-stage liver disease (MELD) score in predicting early rebleeding and in-hospital mortality in cirrhosis patients complicated by esophageal variceal bleeding. Subject and method: Cross-sectional description of 222 patients with esophageal variceal bleeding with underlying cirrhosis treated at the Department of Gastrointestinal and Internal Medicine Emergency Department - 103 Military Hospital and Digestive Diseases Treatment Institute - 108 Military Central Hospital. Calculate MAP(ASH), MELD, CP scores at the time of admission, compare with the rate of early rebleeding and in-hospital mortality, thereby determining and comparing the prognosis value of these scores through analysis of area under the curve. Result: The rates of rebleeding and in-hospital mortality were 9.0% and 6.8%, respectively. Regarding the prognosis of early rebleeding, the MAP(ASH) score had good prognostic value (AUROC 0.72; 95%CI: 0.59-0.84), while the CP and MELD scores had poor predictive value with AUROC < 0.70. Regarding prognosis of in-hospital mortality: MAP(ASH), MELD scores all had good value with both AUROC equal to 0.83 (p<0.001), while CP only had medium prognostic value with AUROC 0.79 (95%CI: 0.66-0.92; p<0.05). However, the difference between the MAP(ASH), MELD and CP in prognosis was not statistically significant. Conclusion: MAP(ASH) is a valuable score in predicting in-hospital death as well as early rebleeding in cirrhotic patients with esophageal variceal bleeding, better than CP and MELD scores, so it is necessary to recommended for application in clinical practice.
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References
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