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Volume : 08, Issue : 01, January – 2021
59.MELD SCORE. CAN IT BE USED AS A POSSIBLE PREDICTOR OF EARLY RE-BLEED AFTER ACUTE VARICEAL HEMORRHAGE?
Quratulain Tanveer, Sajjad Atique, Syed Naveed Ali Shah, Sami ur Rehman, Sajjad Hussain Chandio, Tehreem Fatima**
Abstract :
Introduction: Treatment with vasoactive drugs, prophylactic antibiotics, and endoscopic techniques is the recommended standard of care for patients with acute variceal bleeding. However, treatment failure occurs in about 10–15% of patients. Model for End-stage Liver Disease (MELD) scoring system is used as a tool to assess the severity of the liver disease. It is now being used as a predictor of survival and variceal rebleeding. The study aimed to determine the positive predictive value of MELD score in predicting rebleeding in chronic liver disease patients undergoing intervention for variceal bleeding taking endoscopic findings as a gold standard.
Methods: A total of 100 patients who had undergone intervention for variceal bleeding and were suspected to have a rebleed on MELD score were enrolled in the study. Patients were called for regular follow up after every 2 weeks for 3 months or in case of hematemesis immediately report to the emergency department and to the study department. The presence of bleeding from the same site was included. All the collected data were entered and analyzed into SPSS v25.0. The positive predictive value was calculated and presented as a percentage. Data were stratified for age, gender, history of diabetes, and INR. The Chi-Square test was applied.
Results: A total of 100 predicted to have rebleeding on MELD score in CLD patients who had undergone endoscopic intervention were enrolled in this study. There were 68(68.0%) males and 32(32.0%) were females. The mean age of subjects was 46.3±14.3 years. The overall frequency of outcome as true positive in patients predicted to have a rebleed on MELD score in CLD patients who had undergone endoscopic intervention was 66(66.0%).
Conclusion: MELD score can be used as a possible predictor of early variceal rebleeding. It can identify patients who are at a substantially increased risk of rebleeding over a short term. Patients having a MELD score of more than 20 have a high risk of rebleed.
Keywords : Chronic Liver Disease, MELD Score, Variceal Bleeding, Acute Variceal Hemorrhage, Re-bleed.
Cite This Article:
Please cite this article in press Tehreem Fatima et al, Meld score. Can it be used as a possible predictor of early re-bleed after acute variceal hemorrhage?. , Indo Am. J. P. Sci, 2021; 08(1).