RESEARCH ARTICLE


AIMS65 and PALBI Scores as Predictors of Six Months’ Mortality in Cirrhotic Patients with Acute Variceal Bleeding



Mohammed Elhendawy1, Alshaimaa Fathy Eldesouky1, Shaimaa S Soliman2, Loai Mansour1, Sherief Abd-Elsalam1, *, Nehad Hawash1
1 Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
2 Public Health & Community Medicine Department, Faculty of Medicine, Menoufia University, Shibin El Kom, Egypt


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Creative Commons License
© 2022 Elhendawy et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, El-Geish Street 31527, Tanta, Egypt, E-mails: sherif_tropical@yahoo.com


Abstract

Background & Aims:

Bleeding gastroesophageal varices are a cause of high mortality among cirrhotic patients. We aimed to investigate late mortality predictors and prognostic models using easily verified factors at admission in cirrhotic patients with acute variceal bleeding (AVB).

Methods:

Between January 2020 and June 2020, 142 patients with AVB from Tanta university hospital were included. Investigating multiple prognostic models was done using multiple logistic regression after identifying significant predictors of 6 months' mortality. Mortality prediction accuracy was assessed with area under the receiver operating characteristic (AUROC) curve.

Results:

The 6 months’ overall mortality rate was 31% (44 patients had died). AIMS56, Child-Turcotte-Pugh (CTP) grade C and MELD scores were significantly higher among non survivors (p<0.001) while Platelet-albumin-bilirubin (PALBI) was significantly more negative among survivors (P=0.001). Hepatocellular carcinoma was not significantly related to the mortality (p =0.364). Univariate analysis showed that high CTP, MELD, AIMS65 and PALBI scores were predictors of mortality and associated with decreased survival with high sensitivity and low specificity; while multivariate analysis showed that only AIMS56 was independently associated with mortality (p 0.004).

Conclusion:

CTP, MELD, AIMS65 and PALBI scores are simple, bed side risk scores that can be used for the prediction of 6 months’ mortality after AVB in cirrhotic patients with high sensitivities and lower specificities.

Keywords: Liver cirrhosis, Portal hypertension, Acute variceal bleeding, Mortality, HCC, Survival.