Prognostic and predictive values of MELD score, platelet count and pre-albumin in patients with compensated and decompensated liver cirrhosis with acute variceal bleeding.

Abstract

The study included 190 patients divided in to 5 groups: 20 normal as healthy control complaining of dyspepsia, GERD etc., 20 patients positive HCV without cirrhosis or varices, 50 patients compensated cirrhosis with varices, 50 patients decompensated cirrhosis with varices and 50 patients with primary acute variceal bleeding. All were subjected to full history taking, clinical examination, routine laboratory examinations including serum pre-albumin, abdominal ultrasonography, MELD score was calculated for all patients, Child classification for all patient and upper gastrointestinal endoscopy. The results showed that platelet count was lowest in patients with varices, decrease of platelet count with increase of grading of esophageal varices. Platelet count was lowest in patients with early bleeding esophageal varices at 6 weeks in comparison to patients with bleeding esophageal varices at 4 months and patients with bleeding esophageal varices at 6 months. MELD score proved to be sensitive and specific in differentiation between patients with and without varices. The increasing of MELD score with increase of grade of varices pre albumin (PA) was lowest in patient with esophageal variceS and decrease of PA level with increase of grade of varices.