MELD-Lactate as a predictor of in-hospital mortality in patients with variceal gastrointestinal bleeding.

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Tác giả: Carlos A Cortez-Hernández, José A González-González, Joel O Jaquez-Quintana, Raúl A Jiménez-Castillo, Héctor J Maldonado-Garza, Sofía Rodríguez-Jacobo

Ngôn ngữ: eng

Ký hiệu phân loại: 297.1248 Sources of Islam

Thông tin xuất bản: Spain : Gastroenterologia y hepatologia , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 581958

 INTRODUCTION: Variceal upper gastrointestinal bleeding is a common cause of decompensation in patients with liver cirrhosis. While mortality data, which are from 10 to 15%, are available, there are no validated scales to predict in-hospital mortality in this patient population. OBJECTIVE: To determine whether the MELD-Lactate (MELD-LA) level is associated with in-hospital mortality in patients with chronic liver disease who are admitted for variceal bleeding. MATERIAL AND METHODS: A prospective, observational, and analytical study was conducted that included 120 patients. The MELD-LA cut-off point was obtained, and in-hospital mortality was obtained using conventional prognostic scales that had the highest sensitivity and specificity for comparison purposes. Additionally, a survival analysis was performed using the MELD-LA cut-off point obtained. RESULTS: In our cohort, 6 (5.0%) patients died during hospitalization. Patients who died had a mean MELD-LA value of 20.0 (±4.97) as opposed to those who did not die, 13.62 (±3.29), (p<
 0.001). The MELD-LA cut-off point of >
 14.0, with a sensitivity of 100%, a specificity of 71.0%, a positive predictive value of 15.4%, a negative predictive value of 100.0%, and an AUC (area under the curve) of 0.886, was most well correlated with higher in-hospital mortality. Survival was 71.1% in patients with MELD-LA levels>
 14.0 versus 100.0% in those with lower levels (p=0.001) during hospitalization. CONCLUSION: The measurement of MELD-LA at admission seems to be a good complementary marker for the evaluation and prognosis of in-hospital mortality in patients with liver cirrhosis, and variceal upper gastrointestinal bleeding.
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