Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 21, 2009; 15(19): 2372-2375
Published online May 21, 2009. doi: 10.3748/wjg.15.2372
Determination of correlation of Adjusted Blood Requirement Index with outcome in patients presenting with acute variceal bleeding
Naheed Akhtar, Bader Faiyaz Zuberi, Syed Riazul Hasan, Raj Kumar, Salahuddin Afsar
Naheed Akhtar, Bader Faiyaz Zuberi, Syed Riazul Hasan, Raj Kumar, Salahuddin Afsar, Department of Medicine, Dow University of Health Sciences, Karachi 74000, Pakistan
Author contributions: Zuberi BF designed the study and carried out the data/statistical analysis; Akhtar N, Hasan SR and Kumar R contributed equally to data collection and manuscript writing; Afsar S performed the final editing and review of the manuscript.
Correspondence to: Dr. Bader Faiyaz Zuberi, Department of Medicine, Dow University of Health Sciences, Karachi 74000, Pakistan. bader@zuberi.net
Telephone: +92-300-8234883
Fax: +92-21-9216027
Received: March 7, 2009
Revised: April 23, 2009
Accepted: April 30, 2009
Published online: May 21, 2009
Abstract

AIM: To determine the correlation of Adjusted Blood Requirement Index (ABRI) with the 7th day outcome in patients presenting with acute variceal bleeding.

METHODS: All patients presenting with acute variceal hemorrhage (AVH) were included. Patients with previous band ligation, sclerotherapy, gastrointestinal or hepatic malignancies were excluded. Patients were managed as per standard protocol for AVH with terlipressin and band ligation. ABRI scores were calculated using the formula outcome of alive or expired up to the 7th day after treatment. The correlation between ABRI and mortality was estimated and a receiver operative characteristic (ROC) curve was plotted.

RESULTS: A total of 113 patients (76 male; 37 female) were included. On assessment, 18 were in Child’s Pugh Class A, 82 in Class B and 13 were in Class C. The median number of blood units transfused ± inter-quartile range was 3.0 ± 2.0. The median ± inter-quartile range for ABRI was 1.3 ± 1.1. The ROC curve of ABRI for expiry showed a significantly large area of 0.848 (P < 0.0001; 95% CI: 0.75-0.95). A significant correlation of log transformation of ABRI with an outcome of mortality was present (P < 0.0001).

CONCLUSION: ABRI correlates strongly with mortality.

Keywords: Adjusted Blood Requirement Index, Cirrhosis, Mortality, Portal hypertension, Variceal hemorrhage