South Clin Ist Euras. 2024; 35(3): 248-252 | DOI: 10.14744/scie.2024.59751

What Is the Ideal Risk Scoring System for Acute Variceal Bleeding in Cirrhotic Patients?

Yavuz Çaðýr¹, Muhammed Bahaddin Durak¹, Cem Simsek², Ilhami Yuksel^1
1Department of Gastroenterology, Ankara City Hospital, Ankara, Türkiye
²Department of Gastroenterology, Health Sciences University, Mehmet Akif Ýnan Training and Research Hospital, Þanlýurfa, Türkiye

INTRODUCTION: This study aimed to evaluate the predictive capacities of three risk scoring systems, Child-Turcotte-Pugh score (CTP), MELD score (Model for End-Stage Liver Disease), and AIMS65 score, in anticipating 3-month rebleeding and mortality in cirrhotic patients presenting with acute variceal bleeding (AVB).
METHODS: At the time of initial presentation, we prospectively collected patients’ medical histories, vital signs, laboratory results, endoscopic findings, and interventions. Clinical out-comes were defined as 3-month rebleeding and mortality.
RESULTS: Among the three scoring systems, the CTP and MELD scores demonstrated comparable abilities to predict 3-month rebleeding, both statistically superior to the AIMS65 score (AUC: 0.676, 0.665, 0.558, respectively). The predictive capacities of the three scoring systems (CTP, MELD, AIMS65) for 3-month mortality were similar and demonstrated high accuracy (AUC: 0.861, 0.753, 0.769, respectively). In the high-risk patient group, the MELD scores showed significant sensitivity (87.5%).
DISCUSSION AND CONCLUSION: The three scoring systems, which are easy to calculate, may be useful in predicting rebleeding and mortality, with the CTP score being particularly beneficial.

Keywords: AIMS65 score, Child-Turcotte-Pugh score, MELD score, mortality; rebleeding.

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Sirotik Hastalarda Akut Varis Kanamasý Ýçin Ýdeal Risk Puanlama Sistemi Nedir?

Yavuz Çaðýr¹, Muhammed Bahaddin Durak¹, Cem Simsek², Ilhami Yuksel^1
1
2

GÝRÝÞ ve AMAÇ: Akut varis kanamasý ile baþvuran sirotik hastalarda 3 aylýk yeniden kanama ve mortaliteyi tahmin etmede üç risk skorlama sisteminin (Child-Turcotte-Pugh skoru (CTP), MELD skoru ve AIMS65 skoru) prediktivitesini deðerlendirilmesi amaçlandý.
YÖNTEM ve GEREÇLER: Baþvuru sýrasýnda, hastalarýn týbbi öykülerini, vital bulgularýný, laboratuvar sonuçlarýný, endoskopik bulgularýný ve müdahalelerini prospektif olarak topladýk. Klinik sonuçlar 3 aylýk tekrar kanama ve mortalite olarak tanýmlandý.
BULGULAR: Üç skorlama sistemi arasýnda, CTP ve MELD skorlarý, her ikisi de AIMS65 skorundan istatistiksel olarak daha üstün olan (sýrasýyla, AUC: 0.676, 0.665, 0.558) 3 aylýk yeniden kanamayý predikte etmede benzer doðrulukta idi. Üç puanlama sisteminin (CTP, MELD, AIMS65) 3 aylýk mortaliteyi öngörme kapasiteleri benzerdi ve yüksek doðruluk gösterdi (sýrasýyla, AUC: 0.861, 0.753, 0.769). Yüksek riskli hasta grubunda MELD skorunun duyarlýlýðý daha anlamlý idi (%87.5).
TARTIÞMA ve SONUÇ: Hesaplanmasý kolay olan üç skorlama sistemi, özellikle CTP skoru olmak üzere, tekrar kanama ve mortaliteyi öngörmede faydalý olabilir.

Anahtar Kelimeler: Akut varis kanamasý, AIMS65 skoru, Child-Turcotte-Pugh skoru, son dönem karaciðer hastalýðý modeli.

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