الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
The aim of this prospective study was to assess the clinical utility of Child-pugh,ALBI and MELD scores in prediction of six-week mortality rate in the patients presented by acute esophageal varical bleeding in patients with liver cirrhosis.
This prospective cohort study included 100 consecutive adult cirrhotic patients presented by acute esophageal variceal bleeding at emergency room and undergone upper GI endoscopy at the Tropical Medicine and Gastroenterology department, Sohag University Hospital. Complete medical history, clinical examination and laboratory work up about these patients were performed and followed up through six-week.
Seum creatinine , ALT and AST were significant predictors of six-week mortality rate On the other hand hemoglobin level ,international normalization ratio, serum albumin level, serum bilirubin level, prothrombin time and concentration ,total leucocytic count and platelet didn’t show significant difference between those patient.
The high mortality rate was found in the patients who had lower mean values of serum creatinine , ALT and AST (P= 0.02, P= 0.03 .p=,007) respectively.
Also there was a significant difference between patients as regard Child-pugh score and MELD score (P= 0.002, P= 0.01 ) respectively. but there is no significance difference to compare between those patients as regard ALBI score (p= 0,12)
Child-pugh score is more accurate in predicting of 6-week mortality rate in the cirrhotic patient presented by acute variceal bleeding with cut of point(>8) and largest area under curve (0.72) followed by MELD score ( cut off > 9) which had AUC about (0.68 )then The ALBI score( cut off > -0.8) with AUC about ( 0.63).
In conclusion, we have demonstrated that the creatinine , ALT and AST was significant in predicting of six-week mortality rate On the other hand hemoglobin level ,international normalization ratio, serum albumin level, serum bilirubin level, prothrombin time and concentration ,total leucocytic count and platelate didn’t show significant difference between those patient as regard to Lab investigation .
Ascites and encephalopathy was significant as regard to clinical features , and the main cause of death was hematemesis in those patient and between alive patient who undergo upper re- endescopy ,band ligation was done .
RECOMMENDATIONS:
1-Large number of patients
2-Multicenters study
3-Follow up of patients after six weeks.