Evaluation of Prognosis in Cirrhotic Patients with Esophageal Variceal Bleeding Using Non-Invasive Scores
Medicina (Lithuania), cilt.61, sa.12, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 61 Sayı: 12
- Basım Tarihi: 2025
- Doi Numarası: 10.3390/medicina61122194
- Dergi Adı: Medicina (Lithuania)
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Directory of Open Access Journals
- Anahtar Kelimeler: esophageal variceal bleeding, treatment, prognosis, CTP and MELD, non-invasive scores, King's score
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background and Objectives: The aims of this study were to evaluate and compare the effectiveness of the Child–Turcotte–Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores, as well as the non-invasive fibrosis scores of the aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4), the Göteborg University Cirrhosis Index (GUCI), and the King’s score, in determining the 6-week and 6-month prognoses in cirrhotic patients with EVB. Materials and Methods: Cirrhotic patients presenting with EVB and admitted to Adana City Training and Research Hospital between September 2017, and October 2022 were included in this study. CTP, MELD, APRI, FIB-4, King’s, and GUCI scores were recorded. The CTP stage and CTP, MELD, APRI, FIB-4, King’s, and GUCI scores were compared according to the 6-week and 6-month prognoses of the patients, and a receiver operating characteristic (ROC) analysis was performed. Results: The mean age of the patients was 59.4 ± 13.9 years, and 55 (64.7%) were male. The 6-week and 6-month mortality rates were 21.2% and 28.2%, respectively. The CTP, MELD, APRI, FIB-4, King’s, and GUCI scores were compared according to the 6-week and 6-month prognoses of the patients. All scores were significantly different between survivors and non-survivors (p < 0.05). The MELD, CTP, and King’s scores were identified as the most effective scores for predicting 6-week mortality (area under the ROC curve (AUC) of 0.888, 0.857, and 0.770, respectively). The MELD, CTP, and King’s scores were identified as the most effective scores for predicting 6-month mortality (AUC of 0.835, 0.823, and 0.734, respectively). Conclusions: The prognosis of cirrhotic patients presenting with EVB is poor. CTP, MELD, APRI, FIB-4, King’s, and GUCI scores were statistically significantly higher in non-survivors than in survivors. CTP and MELD scores were found to be more effective than non-invasive scores in predicting 6-week and 6-month prognoses. The most effective non-invasive score was the King’s score.