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• W2807129894 abstract "Acute variceal bleeding (AVB) results from rupture of esophageal or gastric varices. It is a serious complication of portal hypertension (PH), with substantial morbidity and mortality. In AVB, Child-Pugh (Child) and MELD high scores are related to the higher degree of hepatic dysfunction and worse prognosis. The use of Rockall, Glasgow-Blatchford (GBS) and AIMS65 scores are validated in risk stratification for non-variceal acute gastrointestinal bleeding, but they are controversial in AVB. To evaluate the application of Child, MELD, Rockall, GBS and AIMS65 scores in risk stratification for rebleeding and/or mortality in AVB. A retrospective study was carried out using medical records from patients with upper gastrointestinal bleeding treated at a tertiary care hospital from January 2016 to May 2017. Clinical, laboratory, endoscopic findings and prognostic scores were evaluated in addition to the outcome at 6 weeks. In this period, 378 patients with upper gastrointestinal bleeding were admitted, 279 with non-variceal bleeding and 99 variceal bleeding. We studied 91 patients with AVB secondary to esophageal varices and gastroesophageal varices type 1 (GOV1). There was a predominance of males (66%). Mean age was 55 years. Hepatic cirrhosis (HC) was the main cause of PH (94.5%). Alcohol was the main etiological factor for HC (49%). The most frequent initial manifestation was hematemesis (78%). Most patients were classified as Child B (42.9%) or C (20%), with a mean MELD score of 13 ± 5.6. Approximately 7% of the patients presented with active bleeding. The main endoscopic therapy used was band ligation, in 92.3%. At 6-weeks, the rate of rebleeding was 7.7% and the mortality rate was 11%. Comparing the groups with and without rebleeding, we observed that the Child and GBS scores were higher in the group that rebleeding (9.5 ± 2.3 vs 7.5 ± 2.0, p = 0.05 and 15.1 ± 2.9 vs 12.6 ± 3.3, p = 0.06), with no difference in Rockall score (4 ± 2.4 vs 3.9 ± 2, p = 0.89) or AIMS65 score (1.7 ± 1 vs 1.3 ± 0.9, p = 0.33). Comparing patients who died with those who survived, we observed that the first group had worse liver function (85.7% were Child C), with higher score in Child (10.8 ± 1.4 vs 7.4 ± 1.9, p = 0.0003) and MELD (22.1 ± 8.4 vs 12.9 ± 4.5, p = 0.0015). Patients who died had significantly higher Rockall (5.3 ± 2.5 vs 3.8 ± 1.9, p = 0.04), GBS (14.7 ± 3.3 vs 12.6 ± 3.2, p = 0.02), and AIMS65 scores (2.1 ± 0.9 vs 1.2 ± 0.9, p = 0.03). The rate of rebleeding was 7.7%. This rate appears to be associated with higher Child and GBS scores. The mortality rate was 11%. Liver dysfunction was associated with risk of death. The use of Rockall, GBS and AIMS65 scores is useful for predicting mortality in AVB." @default.
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• W2807129894 date "2018-06-01" @default.
• W2807129894 modified "2023-10-01" @default.
• W2807129894 title "Mo1150 APPLICATION OF ROCKALL, BLATCHFORD AND AIMS65 SCORES TO RISK STRATIFICATION FOR ACUTE VARICEAL BLEEDING" @default.
• W2807129894 doi "https://doi.org/10.1016/j.gie.2018.04.1911" @default.
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