Platelet-albumin-bilirubin score for prediction of complications in cirrhotic patients with acute variceal bleeding

Background: Acute variceal bleeding as a cause of upper gastrointestinal tract hemorrhage is a serious problem that resulting in early death of cirrhotic patients. So, predicting the risk of early re-bleeding and death is crucial for preventing morbidity and mortality. Nowadays , there are multiple scoring systems with good prognostic power have been developed, but there is still a need to find an easier and better scores that can be applied in clinical practice within each population and country. Aim: evaluation of the role of ALBI and PALBI scores as a prognostic tools in cirrhotic patients with variceal bleeding. Methodology: cross-sectional prospective study , done on patients admitted to Hepatology, Gastroenterology and Infectious diseases department at Beni-Suef University Hospital in Egypt who complained of acute onset of variceal bleeding. ALBI and PALBI were calculated and correlated with rates of hospital rebreeding and mortality. Results: This study was done on 100 patients. The rates of first attack of bleeding, rebreeding and in-hospital mortality were 43 patients (43%), 37patients (37%) and 20 patients (20%). Age was a significant risk factor for in hospital morbidity and mortality (P= 0.008*) . Hb, WBCs, PLTs, Creatinine, liver enzymes (AST, ALT) and Bilirubin (T, D) had a statically significant relation to re-bleeding. Regarding hospital mortality, ALBI , PALBI and MELD scores have a better prognostic value in prediction of mortality with AUC 0.726, 0.798 and 0.750 respectively. Conclusion: ALBI, PALBI and MELD scores were helpful for prediction of hospital mortality in patients with variceal bleeding.