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Lin LY, Zeng DW, Liu YR, Zhu YY, Huang LL. Diagnostic value of liver stiffness measurement combined with risk scores for esophagogastric variceal bleeding in patients with hepatitis B cirrhosis. Eur J Radiol 2024; 173:111385. [PMID: 38377895 DOI: 10.1016/j.ejrad.2024.111385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/15/2024] [Accepted: 02/16/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE To assess the predictive value of liver stiffness measurement (LSM) and three bleeding risk scoring systems for esophagogastric varices bleeding (EGVB) in patients with hepatitis B cirrhosis during hospitalization. METHODS In this study, 210 patients who had hepatitis B cirrhosis were selected as the subjects. They were categorized into two groups based on whether EGVB occurred during hospitalization: a bleeding group (70 cases) and a non-bleeding group (140 cases). Logistic regression was used to analyze the factors related to the occurrence of EGVB, and the diagnostic performance was evaluated using a receiver operating characteristic (ROC) curve. RESULTS Significant differences were observed between the two groups in systolic blood pressure, platelet count, albumin, urea nitrogen, LSM, pre-endoscopic Rockall score (PRS), Glasgow-Blatchford score (GBS), and AIMS65 score (P < 0.05). The correlation analysis showed that LSM had significant positive relationship with PRS, GBS and AIMS65 score. Logistic regression analysis revealed that LSM and GBS score were independent risk factors for EGVB occurrence during hospitalization. ROC curve analysis showed that the combined prediction model of LSM and GBS score had the best prediction performance for EGVB occurrence, with an ROC curve area of 0.811, which was significantly better than the three risk scoring systems (P < 0.05), but similar to the predicted value of LSM (P = 0.335). CONCLUSIONS The combination of LSM and GBS score can significantly improve the predictive efficacy of EGVB occurrence in patients with hepatitis B cirrhosis during hospitalization, which has important clinical significance for patients' prognosis.
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Affiliation(s)
- Li-Yan Lin
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Da-Wu Zeng
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China; Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, Fujian Province, China
| | - Yu-Rui Liu
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China; Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, Fujian Province, China
| | - Yue-Yong Zhu
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China; Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, Fujian Province, China; Fujian Key Laboratory of Precision Medicine for Cancer, Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Ling-Ling Huang
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China; Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, Fujian Province, China.
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Zeng F, Du L, Ling L. Lactate level as a predictor of outcomes in patients with acute upper gastrointestinal bleeding: A systematic review and meta‑analysis. Exp Ther Med 2024; 27:113. [PMID: 38361514 PMCID: PMC10867736 DOI: 10.3892/etm.2024.12401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 11/22/2023] [Indexed: 02/17/2024] Open
Abstract
There remains no consensus on the prognostic value of lactate in predicting adverse outcomes such as mortality, rebleeding and higher intensive care unit (ICU) admission rates in patients with upper gastrointestinal bleeding (UGIB). The present study aimed to determine the prognostic accuracy of lactate level in predicting adverse clinical outcomes in patients with acute UGIB. Systematic literature search was conducted in PubMed Central, SCOPUS, EMBASE, MEDLINE, Google Scholar and ScienceDirect databases for studies published up to February 2023. Random-effects model was used for the meta-analysis and the results were presented as pooled standardized mean differences or odds ratio (OR) with 95% confidence interval (CIs). A total of 11 studies were included in the present review. Most of the studies had a high risk of bias. Pooled OR were as follows: 1.39 (95% CI: 1.29-1.51; I2=85%) for the prediction of mortality; 1.29 (95% CI: 1.17-1.42; I2=85.9%) for prediction of ICU admission, 1.14 (95% CI: 1.06-1.23; I2=42.4%) for rebleeding and 2.84 (95% CI: 2.14-3.77; I2=8.1%) for the need of packed red blood cell (pRBC) transfusion. Sensitivity and specificity for the mortality prediction were 72% (95% CI: 57-83%) and 75% (95% CI: 61-85%), respectively, with the area under the curve of 0.79 (95% CI: 0.72-0.85). In conclusion, the results showed that lactate level is a moderately accurate early prediction marker of most adverse clinical outcomes such as mortality, rebleeding, ICU admission and the need for pRBC transfusion in acute UGIB patients.
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Affiliation(s)
- Fanshu Zeng
- Department of Emergency, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, P.R. China
| | - Li Du
- Department of Gastroenterology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, P.R. China
| | - Ling Ling
- Department of Radiology Center, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, P.R. China
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Zhang SY, Zhu XQ, Chen LH, He Y, Jing AM. Progress in research of risk prediction models for upper gastrointestinal bleeding. Shijie Huaren Xiaohua Zazhi 2023; 31:695-704. [DOI: 10.11569/wcjd.v31.i17.695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 09/08/2023] Open
Abstract
Upper gastrointestinal bleeding is a common gastrointes-tinal condition with a high incidence rate and great harm to the body. This paper reviews the rebleeding, endos-copic intervention, and death risk prediction models for upper gastrointestinal bleeding, including the study population, research methods, related risk factors, and model performance, in order to provide reference for clinicians to conduct risk assessment as soon as possible, formulate effective prevention and management plans, and improve patient survival outcomes.
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Affiliation(s)
- Shi-Yi Zhang
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Xiu-Qin Zhu
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Li-Hong Chen
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Yuan He
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - A-Min Jing
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
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