GIÁ TRỊ CỦA ĐIỂM MELD 3.0 TRONG TIÊN LƯỢNG Ở BỆNH NHÂN XƠ GAN CÓ CHẢY MÁU TIÊU HÓA CẤP DO VỠ GIÃN TĨNH MẠCH THỰC QUẢN - DẠ DÀY

Abstract

Objectives: To investigate the value of the MELD 3.0 score in predicting short-term rebleeding and mortality in cirrhotic patients with acute gastrointestinal bleeding (GIB) due to esophageal-gastric variceal rupture. Methods: A descriptive, longitudinal study with a 6-week follow-up was conducted on 119 cirrhotic patients with acute GIB due to esophageal-gastric variceal rupture, treated at the Department of Gastroenterology and the Department of Medical Intensive Care, Military Hospital 103, from June 2024 to April 2026. The MELD 3.0 score was calculatedand compared with the rates of rebleeding and mortality during the 6-week follow-up from the onset of bleeding. Results: The MELD 3.0 score demonstrated good predictive value for short-term mortality (AUC = 0.815; 95%CI: 0.707 - 0.922; p < 0.001), with a cut-off value of 20.5, showing a sensitivity of 81.0%, a specificity of 76.5%, and a negative predictive value of 94.9%. However, it had limited value in predicting rebleeding (AUC = 0.637). Conclusion: The MELD 3.0 score is a good predictor of 6-week mortality in cirrhotic patients with acute GIB due to esophageal-gastric variceal rupture, while it has limited value in forecasting rebleeding.