COMPARING THE PREDICTIVE EFFICACY OF MELD AND ALBI SCORES IN LIVER CIRRHOSIS PATIENTS WITH ACUTE UPPER GASTROINTESTINAL BLEEDING.

BACKGROUND

Acute upper gastrointestinal bleeding (AUGIB) is a critical medical emergency and is a common cause of illness and death in individuals with liver cirrhosis.

OBJECTIVE

The point of this study was to check how well the albumin-to-bilirubin ratio (ALBI) and model for end-stage liver disease (MELD) scores could predict how these patients would do in the future.

METHODS

The Imam Khomeini Hospital gastroenterology department conducted a retrospective examination. We admitted 102 patients with AUGIB and liver cirrhosis from April 2021 to September 2023. The study included a full medical history and clinical evaluation upon admission, as well as all laboratory test results throughout the hospital stay. We diagnosed liver cirrhosis using clinical, laboratory, and radiologic data. We diagnosed AUGIB as having hematemesis, melena, or hematochezia. We then tested the ALBI, MELD, and liver and kidney function. Some criteria allow continuous variable comparison, whereas others allow discrete variable comparison. Death during hospitalization and rebleeding were the key outcomes, with one-month mortality assessed. We compared ALBI and MELD before establishing their relationship to mortality and rebleeding.

RESULTS

Of the 102 patients, 68.5% survived. Upon arrival, we noted a markedly elevated prevalence of edema, ascites, and chilly extremities among patients who did not survive. The MELD and ALBI scoring systems effectively forecast in-hospital mortality. The threshold for MELD is 21 (CI: 0.759-0.930, P=0.00), whereas for ALBI it is -2.3 (CI: 0.865-0.950, P=0.01). Neither party could foresee hospitalization or premature rebleeding. The probability of death may be forecasted using the MELD during the first discharge phase (P<0.05).

CONCLUSION

The MELD and ALBI scores show a suitable ability to predict short-term outcomes and both of them can predict death and rebleeding, as well as 1-month mortality. Nevertheless, we recommend that in individuals with advanced liver cirrhosis, the MELD score is a more accurate prognostic indicator compared to the ALBI score.