MELD score and hepatocellular carcinoma identify patients at different risk of short-term mortality among cirrhotics bleeding from esophageal varices.
OBJECTIVE
The role of model for end stage liver disease (MELD) and the presence of hepatocellular carcinoma (HCC) as risk factors of short-term mortality in patients bleeding from oesophageal varices were evaluated.


METHODS
From February 2002 to August 2003, 172 cirrhotic patients admitted for the first episode of bleeding from oesophageal varices received vasoactive and endoscopic therapy. Patients' survival was evaluated at 6 weeks and 3 months. The role of MELD and HCC as independent risk factors of mortality was evaluated.


RESULTS
In the 172 patients, the overall mortality was 21.5% at 6 weeks and 30.2% at 3 months. MELD score resulted a good predictor of mortality either at 6 weeks or 3 months. Fifty-four patients (31.3%) had HCC. The presence of advanced HCC was an independent risk factor of mortality at 3 months. Patients with MELD score>15 and advanced HCC had a significantly worse survival than patients with MELD<or=15 and without HCC or with early HCC either at 6 weeks or 3 months


CONCLUSIONS
MELD score and the presence of HCC allow to identify patients at different risk of short-term mortality among cirrhotic patients at first episode of bleeding from oesophageal varices.
Amitrano
Lucio
L
Department of Gastroenterology, A. Cardarelli Hospital, Via Cardarelli 9, 80131 Napoli, Italy. luamitra@tin.it
Guardascione
Maria Anna
MA
Bennato
Raffaele
R
Manguso
Francesco
F
Balzano
Antonio
A
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000503:physiopathology; D004932:Esophageal and Gastric Varices / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality* / Q000503:physiopathology; D008113:Liver Neoplasms / Q000401:mortality* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis