Fong Tze-Vun, Hung Fu-Chih, Chiu King-Wah, Chiu Yi-Chun, Wu Keng-Liang, Kuo Chung-Huang, Kuo Chung-Mo
Division of Hepato-Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Hepatogastroenterology. 2008 May-Jun;55(84):1055-8.
BACKGROUND/AIMS: Esophageal varices bleeding is a fatal complication of portal hypertension. The model for end-stage liver disease (MELD) has been used as a tool to predict mortality risk in cirrhotic patients. It is currently unknown if MELD score can be applied to predicting late esophageal varices rebleeding. The predictive ability of the MELD score for short-term esophageal varices rebleeding was studied.
Ninety-five cirrhotic patients with esophageal varices bleeding were enrolled with a follow up period of at least 3 months. All patients had undergone a successful hemostasis at admission. Initial admission MELD score and 3-months MELD were obtained to observe their correlation with the late esophageal varices rebleeding.
MELD score of 13 and 16 are the mean MELD score of the admission and 3-months respectively in the rebleeding group. The correlation between initial admission MELD score and late stage data showed a positive linear regression in the rebleeding patients (p=0.001, r=0.773) but not in the non-rebleeding group.
The MELD score is a good predictor of short term esophageal varices rebleeding rate. At least 2 MELD score data is needed to evaluate the possibilities of rebleeding
背景/目的：食管静脉曲张出血是门静脉高压的一种致命并发症。终末期肝病模型（MELD）已被用作预测肝硬化患者死亡风险的工具。目前尚不清楚MELD评分是否可用于预测晚期食管静脉曲张再出血。本研究探讨了MELD评分对食管静脉曲张短期再出血的预测能力。
纳入95例食管静脉曲张出血的肝硬化患者，随访期至少3个月。所有患者入院时均成功止血。获取入院时的初始MELD评分和3个月时的MELD评分，以观察它们与晚期食管静脉曲张再出血的相关性。
再出血组入院时和3个月时的平均MELD评分分别为13分和16分。再出血患者中，入院时初始MELD评分与晚期数据之间的相关性呈正线性回归（p = 0.001，r = 0.773），而非再出血组则无此相关性。
MELD评分是食管静脉曲张短期再出血率的良好预测指标。评估再出血可能性至少需要2个MELD评分数据
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