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Model of Augustin et al for Predicting Mortality in a Patient with Acute Esophageal Variceal Bleeding

Description

Augustin et al reported a model for predicting short-term mortality for a patient with acute esophageal variceal bleeding. This can help to identify a patient who may benefit from more aggressive management. The authors are from Universitat Autonoma de Barcelona.


Patient selection: acute esophageal variceal bleeding

 

Outcome: 6-week mortality

 

High risk:

(1) Child Pugh grade C

(2) Child Pugh grade B and active bleeding

 

Parameters:

(1) Child Pugh Score from 5 to 15

(2) hepatocellular carcinoma

(3) serum creatinine in mg/dL

 

Parameter

Finding

Points

Child Pugh Score

 

0.475 * (score)

hepatocellular carcinoma

no

0

 

yes

1.746

serum creatinine

< 1.0 mg/dL

0

 

>= 1.0 mg/dL

1.179

 

X =

= SUM(points for all 3 parameters) - 7.226

 

probability of 6-week mortality =

= 1 / (1+EXP((-1) * X))

 

Child Pugh class

Creatinine

HCC

6-week mortality

A

< 1.0

no

1.1%

A

< 1.0

yes

5.9%

A

>=1.0

no

4.2%

A

>=1.0

yes

19.7%

B

< 1.0

no

2.7%

B

< 1.0

yes

13.4%

B

>=1.0

no

9.8%

B

>=1.0

yes

37.7%

C

< 1.0

no

13.1%

C

< 1.0

yes

45.6%

C

>=1.0

no

37%

C

>=1.0

yes

76.6%

 


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