%0 Journal Article
%T Valoraci¨®n del pron¨®stico a corto y largo plazo de pacientes con cirrosis y hemorragia digestiva por hipertensi¨®n portal
%A Sempere
%A L.
%A Palaz¨®n
%A J. M.
%A S¨¢nchez-Pay¨¢
%A J.
%A Pascual
%A S.
%A Madaria
%A E. de
%A Poveda
%A M. J.
%A Carnicer
%A F.
%A Zapater
%A P.
%A P¨¦rez-Mateo
%A M.
%J Revista Espa£¿ola de Enfermedades Digestivas
%D 2009
%I The Spanish Society of Digestive Pathology
%R 10.4321/S1130-01082009000400002
%X objective: to evaluate the efficacy of various indicators in predicting short- and long-term survival in patients with cirrhosis and acute variceal bleeding. material and methods: prognostic indicators were calculated for a cohort of 201 cirrhotic patients with acute variceal bleeding hospitalized in our center, a third-level teaching hospital. the studied variables were: age, sex, etiology of cirrhosis, endoscopic findings, previous variceal bleeding episodes, human immunodeficiency virus (hiv) infection, hepatocellular carcinoma (hcc), infection during episode, and child-turcotte-pugh (ctp) and model for end-stage liver disease (meld) scores within 24 hours of bleeding onset. patients were followed up for at least 6 months until death, liver transplantation, or end of observation. results: median follow-up was 66.85 weeks (range 0-432.4). the 6-week, 3-month, 12-month and 36-month mortality rates were 22.9, 24.9, 34.3, and 39.8%, respectively. age ¡İ 65 years, presence of hcc, ctp score ¡İ 10, and meld score ¡İ 18 were the variables associated with mortality in the multivariate analysis. the accuracy of meld scores as predictors of 6-week, 3-month, 12-month, and 36-month mortality was better than that of ctp scores (c-statistics: 6 week meld 0.804, ctp 0.762; 3-month meld 0.794, ctp 0.760; 12-month meld 0.766, ctp 0.741; 36 month meld 0.737, ctp 0.717). conclusion: meld and ctp scores together with age and a diagnosis of hepatocellular carcinoma are useful indicators to assess the short- and long-term prognosis of patients with acute variceal bleeding.
%K prognosis
%K variceal bleeding
%K portal hypertension
%K child-turcotte-pugh score
%K meld score.
%U http://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S1130-01082009000400002&lng=en&nrm=iso&tlng=en