Prognostic value of AIMS65 score in cirrhotic patients with variceal bleeding

Background: In cirrhotic patients, variceal bleeding remains a major cause of death. After a variceal bleeding episode, mortality and rebleeding rates spike for the first 6 weeks before levelling off. We aimed to evaluate the performance of AIMS65 score in comparison with Child-Turcotte-Pugh (CTP) score and model for end-stage liver disease (MELD) score in predicting 6-week mortality and rebleeding in cirrhotic patients with variceal bleeding. Method: Data were collected prospectively from patients with cirrhosis and variceal bleeding at Gastroenterology and Hepatology Department of Cho Ray hospital from September 2016 to April 2017. The primary endpoint was 6-week mortality and rebleeding. The prognostic value of AIMS65, CTP, and MELD scoring systems for 6-week mortality and rebleeding was compared by receiver operating characteristics curves (ROC) and the area under the curve (AUC). Results: Among 80 patients, 15% rebled and 25% died during 6-week follow-up. AUCROC of AIMS65, CTP, and MELD scores in predicting 6-week rebleeding were 0.68, 0.54, and 0.48, respectively. AUCROC of AIMS65, CTP, and MELD scores in predicting 6-week mortality were 0.80, 0.74, and 0.64, respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of AIMS65 score at the cutoff point of 2 were 95%, 55%, 41.3%, and 97%, respectively. Conclusion: AIMS65 score is a simple yet applicable tool for risk stratification in cirrhotic patients with variceal bleeding. We recommend using AIMS65 score with a cut-off point of 2 to identify patients at increased risk for 6-week mortality after variceal bleeding.

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Prognostic Value of Serum Exosomal AHCY Expression in Hepatitis B-Induced Liver Cirrhosis

Frontiers in Medicine ◽

10.3389/fmed.2021.777452 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ling Tong ◽

Cuilin Yan ◽

Minjie Wang ◽

Jiajia Yang ◽

Hongmei Wang ◽

...

Keyword(s):

Liver Cirrhosis ◽

Hepatitis B ◽

Prognostic Value ◽

Survival Curve ◽

Area Under The Curve ◽

Meld Score ◽

Mortality Prediction ◽

Operating Characteristics ◽

Serum Samples ◽

Prediction Ability

Objective: We aimed to investigate serum exosomal adenosylhomocysteinase (AHCY) expression in hepatitis B-induced liver cirrhosis (HBV-LC) patients and to determine the prognostic value of serum exosomal AHCY.Methods: We collected serum samples from 100 patients with chronic hepatitis B (CHB) and from 114 HBV-LC patients to test serum exosomal AHCY expression using ELISA.Results: Compared with the CHB and Grade A and B HBV-LC groups, the level of exosomal AHCY expression was significantly higher in the HBV-LC group [376.62 (291.50–448.02) vs. 248.12 (189.28–324.63), P > 0.001] and the Grade C HBV-LC group [408.70 (365.63–465.76) vs. 279.76 (215.16–336.07), P > 0.001], respectively. Serum exosomal AHCY expression and MELD score had a significant positive correlation (r = 0.844, P < 0.001). Survival curve analysis showed that patients with low exosomal AHCY expression had significantly longer survival than patients with high exosomal AHCY expression (P = 0.0038). The receiver operating characteristics (ROC) curve showed that the area under the curve (AUC) value for the mortality prediction ability of serum exosomal AHCY in HBV-LC patients was 0.921, which was higher than the values for the MELD score (AUC 0.815) and Child-Pugh classification (AUC 0.832), with a sensitivity and specificity of 93.41 and 76.00%, respectively.Conclusions: The serum exosomal AHCY level is a novel potential prognostic biomarker in HBV-LC patients, which may be great significance for the prognosis of HBV-LC patients.

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Prognostic value of risk scoring systems for cirrhotic patients with variceal bleeding

World Journal of Gastroenterology ◽

10.3748/wjg.v25.i45.6668 ◽

2019 ◽

Vol 25 (45) ◽

pp. 6668-6680 ◽

Cited By ~ 1

Author(s):

Xin-Xing Tantai ◽

Na Liu ◽

Long-Bao Yang ◽

Zhong-Cao Wei ◽

Cai-Lan Xiao ◽

...

Keyword(s):

Variceal Bleeding ◽

Prognostic Value ◽

Scoring Systems ◽

Risk Scoring ◽

Cirrhotic Patients

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Comparison of different scores as predictors of mechanical ventilation in drug overdose patients

Human & Experimental Toxicology ◽

10.1177/0960327116655389 ◽

2016 ◽

Vol 36 (6) ◽

pp. 539-546 ◽

Cited By ~ 2

Author(s):

Ghada N El-Sarnagawy ◽

Amal SAF Hafez

Keyword(s):

Mechanical Ventilation ◽

Drug Overdose ◽

Predictive Value ◽

Area Under The Curve ◽

Scoring Systems ◽

Apache Ii ◽

Apache Ii Score ◽

Operating Characteristics ◽

Mechanically Ventilated ◽

Significant Difference

The decision of intubation and mechanical ventilation in poisoned patients with impaired consciousness can be a difficult task. The present study aimed to evaluate the power of Glasgow Coma Scale (GCS), acute physiology and chronic health evaluation (APACHE II), rapid acute physiology score (RAPS) and rapid emergency medicine score (REMS) at admission in predicting the need of intubation and mechanical ventilation in drug overdose patients with disturbed consciousness level (DCL). This prospective observational study was conducted on 104 poisoned patients who were admitted to Tanta Toxicological Unit with a DCL. Four scoring systems (GCS, APACHE II, RAPS and REMS) were recorded for all patients on admission. Discrimination was evaluated using receiver operating characteristics curve and calculating the area under the curve (AUC). Twenty-four cases required mechanical ventilation. The mechanically ventilated patients had significantly lower value of GCS and higher values of APACHE II, REMS and RAPS than other group ( p < 0.001). Although the APACHE II score has the best AUC value (0.796) in predicting mechanical ventilation, there was no statistically significant difference between the four scores. GCS > 8 had 100% negative predictive value, while REMS > 8 had 100% positive predictive value.

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PROGNOSTIC VALUE OF MELD SCORE IN CHILD PUGH C CIRRHOTIC PATIENTS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2019.3.9 ◽

2019 ◽

pp. 67-73

Author(s):

Thi Minh Duc Vo ◽

Stackhouse Frank A. ◽

Van Huy Tran

Keyword(s):

Variceal Bleeding ◽

Prognostic Value ◽

Spontaneous Bacterial Peritonitis ◽

Hepatorenal Syndrome ◽

Prognostic Score ◽

Meld Score ◽

Decompensated Cirrhosis ◽

Bacterial Peritonitis ◽

Acute Variceal Bleeding ◽

Cirrhotic Patients

Background and aims: The Model for End Stage Liver Disease (MELD) is a scoring system used for the prioritization of patients waiting for liver transplantation. Patients with decompensated cirrhosis often have serious complications. The aims of this study were to evaluate the prognostic value of MELD score in relation to mortality complications and to acute variceal bleeding, spontaneous bacterial peritonitis, hepatoencephalopathy, hepatorenal syndrome of Child Pugh C Vietnamese cirrhotic patients in a period of six months after hospitalization. Methods: This prospective study includes 102 consecutive Child Pugh C cirrhotic patients who were admitted to the Gastrointestinal Department of Hue Central Hospital and the General Internal Medicine Department of Hue University of Medicine and Pharmacy Hospital, Vietnam, from April 2016 to February 2017. The MELD score of each patient was calculated at admission. All patients were then observed for 6 months to assess the following: acute variceal bleeding, spontaneous bacterial peritonitis, hepatoencephalopathy, hepatorenal syndrome and mortality. Results: The mean MELD score of all patients was 19.5 ± 7.1; of male patients was 19.7 ± 7.4; of female patients was 18.43 ± 4.4; of alcoholic patients was 19.5 ±7.5; and of non – alcoholic patients was 19.6 ± 5.9. The MELD score correlated with mortality during 6 months after hospitalization (with cut – off = 20; AUC = 0,69; sensitivity and specificity were 56.0% and 76.6%) and with hepatorenal syndrome (with cut – off = 25; AUC = 0.90; sensitivity = 83.3% and specificity = 85.4%). In this study, the MELD score did not correlated acute variceal bleeding, spontaneous bacterial peritonitis, hepatoencephalopathy during 6 months after hospitalization. Conclusion: MELD is a valuable prognostic score for mortality and hepatorenal syndrome in Child Pugh C cirrhotic patients in 6 months after hospitalization. Key words: MELD score, Child Pugh C cirrhotic patients

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PROGNOSTIC VALUE OF MELD SCORE IN CHILD PUGH C CIRRHOTIC PATIENTS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.5.16 ◽

2017 ◽

pp. 119-125

Author(s):

Thi Minh Duc Vo ◽

Van Huy Tran ◽

Trong Thang Hoang

Keyword(s):

Sensitivity And Specificity ◽

Variceal Bleeding ◽

Prognostic Value ◽

Hepatorenal Syndrome ◽

Meld Score ◽

University Hospital ◽

Prognostic System ◽

General Internal ◽

Acute Variceal Bleeding ◽

Cirrhotic Patients

Background and aims: Model for End Stage Liver Disease (MELD) is a scoring system used for prioritization of patients waiting liver transplantation. Patients with decompensated cirrhosisoftenshave serious complications. The aims of this study was to evaluate prognostic value of MELD score for complications (mortality, acute variceal bleeding, spontaneous bacteremia peritonitis, hepatoencephalopathy, hepatorenal syndrome) of Child Pugh C cirrhotic patients in 6 months after hospitalizing. Methods: This prospective study included 102 consecutive Child Pugh C cirrhotic patients who were admitted in the period april 2016 to February 2017 in the Gastrointestinal Department, Hue Central Hospital and the General Internal Medicine Department, Hue University Hospital. At admission the MELD score of each patient was calculated. All patients were followed up for 6 months to assess the events: mortality, acute variceal bleeding, spontaneous bacteremia peritonitis, hepatoencephalopathy, hepatorenal syndrome. Results: Mean MELD score of all patients was 19.5 ± 7.1; of male patients was 19.7 ± 7.4; of female ones was 18.43 ± 4.4; of alcoholic ones was19.5 ±7.5; of non - alcoholic ones was 19.6 ± 5.9. MELD score is available to predict mortality for 6 months after hospitalizating (with cut – off 20; AUC 0.69; sensitivity and specificity are 56.0% and 76.6%) and to predict hepatorenal syndrome (with cut – off 25; AUC 0.90; sensitivity and specificity are 83.3% and 85.4%). In this study, prognostic value of MELD score for acute variceal bleeding, spontaneous bacteremia peritonitis, hepatoencephalopathyfor 6 months after hospitalizating have not been found. Conclusions: MELD score is valuable prognostic system for mortality and hepatorenal syndrome in Child Pugh C cirrhotic patients in 6 months after hospitalizing. Key words: cirrhosis, MELD score

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PROGNOSTIC VALUE OF COMBINATION AIMS65 AND MELD SCORES IN CIRRHOTIC PATIENTS WITH ACUTE VARICEAL BLEEDING

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2019.1.6 ◽

2019 ◽

pp. 35-40

Author(s):

Thi Nhung Nguyen ◽

Trung Nam Phan ◽

Van Huy Tran

Keyword(s):

Clinical Practice ◽

Portal Hypertension ◽

Key Words ◽

Variceal Bleeding ◽

Prognostic Value ◽

High Rate ◽

Central Hospital ◽

Acute Variceal Bleeding ◽

Cirrhotic Patients ◽

Sensitivity Specificity

Bacground: Variceal bleeding is a severe complication of portal hypertension due to cirrhosis with high rate of motality, hence, predicting early rebleeding and mortality in cirrhotic patients with acute variceal bleeding is vital in clinical practice. Objectives: To evaluate the prognostic value of the combination of AIMS65 and MELD scores in predicting first 5 days in-hospital rebleeding and mortality in cirrhotic patients with acute variceal bleeding. Materials and Methods: 44 cirrhotic patients with acute variceal bleeding hospitalized at Hue Central Hospital. MELD and AIMS65 scores were calculated within the first 24 hours and monitoring rebleeding and mortality in the first 5 days in these patients. Results: AIMS65, MELD scores can predict first 5 days rebleeding and mortality with AUROC are 0.81, 0.69 and 0.92, 0.95, respectively. Combination of AIMS65 and MELD scores can predict first 5 days in hospital rebleeding with AUROC is 0.84, sensitivity 83.3%, specificity 81.6% (p<0.001) and mortality with AUROC is 0.96, sensitivity 100%, specificity 92.7% (p<0.001). Conclusions: The combination of AIMS65 and MELD scores increased the sensitivity, specificity and prognostic value in predicting first 5 days in-hospital rebleeding and mortality in cirrhotic patients with acute variceal bleeding in compare to each single scores. Key words: AiMS65 score, MELd, acute variceal bleeding

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Performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding

Egyptian Liver Journal ◽

10.1186/s43066-021-00088-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Rehab Elsayed Elsafty ◽

Abdallah Ahmed Elsawy ◽

Ahmed Fawzy Selim ◽

Atef Mohamed Taha

Keyword(s):

Hepatic Encephalopathy ◽

Variceal Bleeding ◽

Early Discharge ◽

Meld Score ◽

Bleeding Control ◽

Acute Variceal Bleeding ◽

Prophylactic Measures ◽

Significant Performance ◽

Cirrhotic Patients ◽

Grade 3

Abstract Background Hepatic encephalopathy exacerbates the morbidity, delays hospital discharge, and increases the rate of readmissions of cirrhotic patients, particularly those are admitted by acute variceal bleeding. We evaluated the performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding, in comparison to Child-Pugh and MELD scores. This prospective cohort study was conducted on 250 cirrhotic patients who were consecutively presented by acute variceal bleeding in the period from January to December 2020 at Tanta university emergency hospital. Albumin-bilirubin, Child-Pugh, and MELD scores were measured at admission, and then all patients were followed up for 4 weeks after endoscopic bleeding control for possible occurrence of hepatic encephalopathy Results Albumin-bilirubin, Child-Pugh, and MELD scores had significant performances in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding; in this regard, albumin-bilirubin score had the highest accuracy (AUC 0.858, CI 0.802-0.914, sig 0.000) followed by Child-Pugh score (AUC 0.654, CI 0.574–0.735, sig 0.001) and then MELD score (AUC 0.602, CI 0.519–0.686, sig 0.031). The cumulative incidence of hepatic encephalopathy in cirrhotic patients with albumin-bilirubin grade 3 was found to be significantly more than that present in albumin-bilirubin grade 2; most of these hepatic encephalopathy cases occurred in the first 2 weeks of follow-up period. Conclusions Albumin-bilirubin score has a significant performance in risk prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding better than Child-Pugh and MELD scores. Albumin-bilirubin grades could be used as a risk stratifying tool to triage cirrhotic patients who will benefit from early discharge after bleeding control and those patients who will benefit from prophylactic measures for hepatic encephalopathy.

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New screening approach to detecting congenital syphilis in China: a retrospective cohort study

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-320549 ◽

2020 ◽

pp. archdischild-2020-320549

Author(s):

Fang Hu ◽

Shuai-Jun Guo ◽

Jian-Jun Lu ◽

Ning-Xuan Hua ◽

Yan-Yan Song ◽

...

Keyword(s):

Predictive Value ◽

Congenital Syphilis ◽

Area Under The Curve ◽

Diagnostic Tools ◽

Operating Characteristics ◽

Loss To Follow Up ◽

Sensitivity Specificity ◽

Mother To Child ◽

Rule Out

BackgroundDiagnosis of congenital syphilis (CS) is not straightforward and can be challenging. This study aimed to evaluate the validity of an algorithm using timing of maternal antisyphilis treatment and titres of non-treponemal antibody as predictors of CS.MethodsConfirmed CS cases and those where CS was excluded were obtained from the Guangzhou Prevention of Mother-to-Child Transmission of syphilis programme between 2011 and 2019. We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) using receiver operating characteristics (ROC) in two situations: (1) receiving antisyphilis treatment or no-treatment during pregnancy and (2) initiating treatment before 28 gestational weeks (GWs), initiating after 28 GWs or receiving no treatment for syphilis seropositive women.ResultsAmong 1558 syphilis-exposed children, 39 had confirmed CS. Area under the curve, sensitivity and specificity of maternal non-treponemal titres before treatment and treatment during pregnancy were 0.80, 76.9%, 78.7% and 0.79, 69.2%, 88.7%, respectively, for children with CS. For the algorithm, ROC results showed that PPV and NPV for predicting CS were 37.3% and 96.4% (non-treponemal titres cut-off value 1:8 and no antisyphilis treatment), 9.4% and 100% (non-treponemal titres cut-off value 1:16 and treatment after 28 GWs), 4.2% and 99.5% (non-treponemal titres cut-off value 1:32 and treatment before 28 GWs), respectively.ConclusionsAn algorithm using maternal non-treponemal titres and timing of treatment during pregnancy could be an effective strategy to diagnose or rule out CS, especially when the rate of loss to follow-up is high or there are no straightforward diagnostic tools.

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First trimester prediction of maternal glycemic status

Journal of Perinatal Medicine ◽

10.1515/jpm-2014-0149 ◽

2015 ◽

Vol 43 (3) ◽

Cited By ~ 8

Author(s):

Rinat Gabbay-Benziv ◽

Lauren E. Doyle ◽

Miriam Blitzer ◽

Ahmet A. Baschat

Keyword(s):

Risk Score ◽

Predictive Value ◽

Challenge Test ◽

Area Under The Curve ◽

First Trimester ◽

Tolerance Test ◽

Oral Glucose ◽

Operating Characteristics ◽

Maternal Characteristics ◽

Predictive Algorithm

AbstractTo predict gestational diabetes mellitus (GDM) or normoglycemic status using first trimester maternal characteristics.We used data from a prospective cohort study. First trimester maternal characteristics were compared between women with and without GDM. Association of these variables with sugar values at glucose challenge test (GCT) and subsequent GDM was tested to identify key parameters. A predictive algorithm for GDM was developed and receiver operating characteristics (ROC) statistics was used to derive the optimal risk score. We defined normoglycemic state, when GCT and all four sugar values at oral glucose tolerance test, whenever obtained, were normal. Using same statistical approach, we developed an algorithm to predict the normoglycemic state.Maternal age, race, prior GDM, first trimester BMI, and systolic blood pressure (SBP) were all significantly associated with GDM. Age, BMI, and SBP were also associated with GCT values. The logistic regression analysis constructed equation and the calculated risk score yielded sensitivity, specificity, positive predictive value, and negative predictive value of 85%, 62%, 13.8%, and 98.3% for a cut-off value of 0.042, respectively (ROC-AUC – area under the curve 0.819, CI – confidence interval 0.769–0.868). The model constructed for normoglycemia prediction demonstrated lower performance (ROC-AUC 0.707, CI 0.668–0.746).GDM prediction can be achieved during the first trimester encounter by integration of maternal characteristics and basic measurements while normoglycemic status prediction is less effective.

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