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Comparison of prognostic scores for Upper Gastrointestinal Bleeding in the Hepato-Gastro-Enterology Department of Campus Teaching Hospital of Lome

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Open Journal of Gastroenterology 2021年第9期11卷 161-171页

作者： Aklesso Bagny Lidawu Roland-Moïse Kogoe Late Mawuli Lawson-Ananissoh Laconi Yeba Kaaga Debehoma Redah Mawunyo Henoc Gbolou Yendoukoa Yves Kanake Departement of Gastroenterology Teaching Hospital Campus of Lome Lome Togo Departement of Gastroenterology University of Lome Lome Togo

Objective: To evaluate and compare the prognostic contribution of different UGIB prognostic scores. Patients and Method: Descriptive cross-sectional study with retrospective collection conducted from January 2014 to December 2019. Patients hospitalized in the Gastroenterology Department of Campus Teaching Hospital of Lome for upper gastrointestinal hemorrhage were included. The analytical component of this study had consisted of an evaluation of the sensitivity and specificity of different prognostic scores (GBS, mGBS, FRS, CRS, AIMS65) in predicting the occurrence of death and/or re-bleeding within 42 days. These different scores were compared using ROC (Receiver Operating Characteristic) curves. Results: We included 314 patients in our study. The male to female sex ratio was 2.48. Fibroscopy found non-related portal hypertension UGIB in 70.94% of the cases. The “FRS” was the most accurate score in predicting death or re-bleeding in all patients. The “FRS” was the most precise score in predicting the occurrence of spotting in all patients. The “FRS” was the most accurate score in predicting death among all patients. The mortality of patients at low risk of death (below the threshold value) was 2.2% for the “FRS”, 9.3% for the “CRS”, 0% for the “GBS” (p = 0.565), 50% for the “mGBS” and 11.4% for the “AIMS65”. Scores were more accurate for non-related portal hypertension UGIB. Conclusion: The “FRS” and the “CRS” are two precise scores in predicting the occurrence of an incident in the event of upper gastrointestinal hemorrhage. However, these scores were less effective in related portal hypertension UGIB.

关键词： Upper Gastrointestinal Bleeding prognostic scores Rockall Glas-gow-Blatchford AIMS65 Lome

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prognostic and diagnostic scoring models in acute alcoholassociated hepatitis:A review comparing the performance of different scoring systems

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世界肝病学杂志:英文版(电子版) 2023年第8期15卷 954-963页

作者： Jad Mitri Mohammad Almeqdadi Raffi Karagozian Department of Medicine Saint Elizabeth’s Medical CenterBostonMA 02135United States Division of Transplant and Hepatobiliary Disease Tufts Medical CenterBostonMA 02111United States Division of Gastroenterology&Hepatology Tufts Medical CenterBostonMA 02111United States

Alcohol-associated hepatitis(AAH)is a severe form of liver disease caused by alcohol *** the absence of confounding factors,clinical features and laboratory markers are sufficient to diagnose AAH,rule out alternative causes of liver injury and assess disease *** to the elevated mortality of AAH,assessing the prognosis is a radical step in *** Maddrey discriminant function(MDF)is the first established clinical prognostic score for AAH and was commonly used in the earliest AAH clinical trials.A MDF>32 indicates a poor prognosis and a potential benefit of initiating *** model for end stage liver disease(MELD)score has been studied for AAH prognostication and new evidence suggests MELD may predict mortality more accurately than *** Lille score is usually combined to MDF or MELD score after corticosteroid initiation and offers the advantage of assessing response to treatment a 4-7 d into the *** commonly used scores include the Glasgow Alcoholic Hepatitis Score and the Age Bilirubin international normalized ratio Creatinine *** AAH correlate adequately with histologic severity scores and leave little indication for liver biopsy in assessing AAH *** presenting as acute on chronic liver failure(ACLF)is so far prognosticated with ACLF-specific scoring *** artificial intelligence-generated prognostic models have emerged and are being studied for use in *** kidney injury(AKI)is one possible complication of AAH and is significantly associated with increased AAH *** AKI and alcohol relapse are important steps in the management of *** aim of this review is to discuss the performance and limitations of different scoring models for AAH mortality,emphasize the most useful tools in prognostication and review predictors of recurrence.

关键词： Alcohol-associated hepatitis prognostic scores Mortality Maddrey discriminant function Model for end stage liver disease Acute kidney injury

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Assessing the prognosis of cirrhotic patients in the intensive care unit:What we know and what we need to know better

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World Journal of Hepatology 2021年第10期13卷 1341-1350页

作者： Fernando da Silveira Pedro H R Soares Luana Q Marchesan Roberto S A da Fonseca Wagner L Nedel Programa de Pos-Graduacao em Pneumologia Universidade Federal do Rio Grande do SulPorto Alegre 91430835Brazil Intensive Care Unit Grupo Hospitalar ConceiçãoPorto Alegre 91430835Brazil Programa de Pos-Graduacao em Neurociencias Universidade Federal do Rio Grande do SulPorto Alegre 91430835Brazil Programa de Pos-Graduacao em Ciencias da Saude Universidade Federal de Santa MariaSanta Maria 97105900Brazil Programa de Pos-Graduacao em Bioquimica Universidade Federal do Rio Grande do SulPorto Alegre 91430835Brazil

Critically ill cirrhotic patients have high in-hospital mortality and utilize significant health care resources as a consequence of the need for multiorgan *** this fact,their mortality has decreased in recent decades due to improved care of critically ill ***-on-chronic liver failure(ACLF),sepsis and elevated hepatic scores are associated with increased mortality in this population,especially among those not eligible for liver *** score is superior to another in the prognostic assessment of these patients,and both liver-specific and intensive care unit-specific scores have satisfactory predictive *** sequential assessment of the scores,especially the Sequential Organ Failure Assessment(SOFA)and Chronic Liver Failure Consortium(CLIF)-SOFA scores,may be useful as an auxiliary tool in the decision-making process regarding the benefits of maintaining supportive therapies in this population.A CLIF-ACLF>70 at admission or at day 3 was associated with a poor prognosis,as well as SOFA score>19 at baseline or increasing SOFA score>*** studies addressing the prognostic assessment of these patients are necessary.

关键词： Cirrhosis Extrahepatic organ failure Organ replacement therapy Mortality prognostic scores Chronic Liver Failure Consortium-Sequential Organ Failure Assessment Sequential Organ Failure Assessment Model for End-stage Liver Disease

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