Biselli et al reported a prognostic score for patients with cirrhosis and acute gastrointestinal bleeding. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in Italy.
Patient selection: cirrhosis and acute gastrointestinal bleeding
Parameters:
(1) MELD-Na
(2) serum albumin in g/dL
(3) previous episode of GI bleeding
(4) corrected QT interval (QTc) in ms
Parameter
Finding
Points
MELD-Na
0.23 * (MELD-Na)
serum albumin
-1.21 * (albumin)
previous GI bleed
no
0
yes
1.15
QTc
<= 456 ms
0
> 456 ms
1.18
score =
= SUM(points for the 4 parameters) * 5
Interpretation:
• The range of the score is set between 1 and 41.
X =
= (0.2 * (score)) - 3.5
Score
Probability of Death Within 6 Weeks
< 4
< 6.3%
4 to 25
1/(1+EXP((-1) * X))
> 25
> 81%
Performance:
• The area under the ROC curve is 0.89.
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