Abstract
Background
Acute variceal bleeding (AVB) is a major cause of death in patients with liver cirrhosis.
The aim of this study was to investigate mortality predictors and develop a new simple
prognostic model using easily verified factors at admission in AVB patients.
Methods
Between January 2009 and May 2015, 333 consecutive patients with AVB were included.
A simplified prognostic model was developed using multiple logistic regression after
identifying significant predictors of 6-week mortality. Mortality prediction accuracy
was assessed with area under the receiver operating characteristic (AUROC) curve.
We compared the new model to existing models of model for end-stage liver disease
(MELD) and Child–Pugh scores.
Results
The 6-week overall mortality rate was 12.9%. Multivariate analysis showed that C-reactive
protein (CRP), total bilirubin, and the international normalized ratio were independent
predictors of mortality. A new logistic model using these variables was developed.
This model’s AUROC was 0.834, which was significantly higher than that of MELD (0.764)
or Child–Pugh scores (0.699). Two external validation studies showed that the AUROC
of our model was consistently higher than 0.8.
Conclusions
Our new simplified model accurately and consistently predicted 6-week mortality in
patients with AVB using objective variables measured at admission. Our system can
be used to identify high risk AVB patients.
Keywords
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Article info
Publication history
Published online: November 24, 2017
Accepted:
November 13,
2017
Received in revised form:
October 22,
2017
Received:
June 19,
2017
Identification
Copyright
© 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
