MELD score and hepatocellular carcinoma identify patients at different risk of short-term mortality among cirrhotics bleeding from esophageal varices

J Hepatol. 2005 Jun;42(6):820-5. doi: 10.1016/j.jhep.2005.01.021. Epub 2005 Apr 7.


Background/aims: The role of model for end stage liver disease (MELD) and the presence of hepatocellular carcinoma (HCC) as risk factors of short-term mortality in patients bleeding from oesophageal varices were evaluated.

Methods: From February 2002 to August 2003, 172 cirrhotic patients admitted for the first episode of bleeding from oesophageal varices received vasoactive and endoscopic therapy. Patients' survival was evaluated at 6 weeks and 3 months. The role of MELD and HCC as independent risk factors of mortality was evaluated.

Results: In the 172 patients, the overall mortality was 21.5% at 6 weeks and 30.2% at 3 months. MELD score resulted a good predictor of mortality either at 6 weeks or 3 months. Fifty-four patients (31.3%) had HCC. The presence of advanced HCC was an independent risk factor of mortality at 3 months. Patients with MELD score>15 and advanced HCC had a significantly worse survival than patients with MELD<or=15 and without HCC or with early HCC either at 6 weeks or 3 months

Conclusions: MELD score and the presence of HCC allow to identify patients at different risk of short-term mortality among cirrhotic patients at first episode of bleeding from oesophageal varices.

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / mortality*
  • Carcinoma, Hepatocellular / physiopathology
  • Esophageal and Gastric Varices / mortality*
  • Esophageal and Gastric Varices / physiopathology
  • Female
  • Gastrointestinal Hemorrhage / mortality*
  • Gastrointestinal Hemorrhage / physiopathology
  • Humans
  • Liver Cirrhosis / mortality*
  • Liver Cirrhosis / physiopathology
  • Liver Neoplasms / mortality*
  • Liver Neoplasms / physiopathology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Risk Factors
  • Severity of Illness Index*
  • Survival Analysis