%0 Journal Article
%T MELD score can predict early mortality in patients with rebleeding after band ligation for variceal bleeding
%A Wei-Ting Chen
%A Chun-Yen Lin
%A I-shyan Sheen
%A Chang-Wen Huang
%J World Journal of Gastroenterology
%D 2011
%I Baishideng Publishing Group Co. Limited
%R 10.3748/wjg.v17.i16.2120
%X AIM: To investigate the outcomes, as well as risk factors for 6-wk mortality, in patients with early rebleeding after endoscopic variceal band ligation (EVL) for esophageal variceal hemorrhage (EVH). METHODS: Among 817 EVL procedures performed for EVH between January 2007 and December 2008, 128 patients with early rebleeding, defined as rebleeding within 6 wk after EVL, were enrolled for analysis. RESULT: The rate of early rebleeding after EVL for acute EVH was 15.6% (128/817). The 5-d, 6-wk, 3-mo, and 6-mo mortality rates were 7.8%, 38.3%, 55.5%, and 58.6%, respectively, in these early rebleeding patients. The use of beta-blockers, occurrence of hypovolemic shock, and higher model for end-stage liver disease (MELD) score at the time of rebleeding were independent predictors for 6-wk mortality. A cut-off value of 21.5 for the MELD score was found with an area under ROC curve of 0.862 (P < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value were 77.6%, 81%, 71.7%, and 85.3%, respectively. As for the 6-mo survival rate, patients with a MELD score ¡Ý 21.5 had a significantly lower survival rate than patients with a MELD score < 21.5 (P < 0.001). CONCLUSION: This study demonstrated that the MELD score is an easy and powerful predictor for 6-wk mortality and outcomes of patients with early rebleeding after EVL for EVH.
%K Model for end-stage liver disease score
%K Esophageal variceal hemorrhage
%K Rebleeding
%K Cirrhosis
%K Mortality
%U http://www.wjgnet.com/1007-9327/full/v17/i16/2120.htm