Objective To investigate the value of Glasgow-Blatchford score ( GBS) , Child-Turcotte-Pugh ( CTP) score, and Model for End-Stage Liver Disease ( MELD) score in predicting the 1-and 6-week prognosis of cirrhotic patients with esophagogastric variceal bleeding via a comparative analysis. Methods A retrospective analysis was performed for the clinical data of 202 cirrhotic patients with esophagogastric variceal bleeding who were hospitalized in Tianjin Third Central Hospital from January 1 to December 31, 2014. According to the endpoint of death at 6 weeks after admission, the patients were divided into 1-week death group ( 10 patients) , 6-week death group ( 23 patients) , and survival group ( 179 patients) . The Glasgow-Blatchford score, MELD score, CTP score, and CTP score and classification were calculated on admission, and these scores were compared between the three groups. The two-independent-samples t test was used for comparison of normally distributed continuous data between groups, and the non-parametric Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. The Z test was used for comparison of the area under the receiver operating characteristic curve ( AUC) of these three scoring systems. Results There were significant differences between the 1-week death group and the survival group in the incidence rates of liver cancer with vascular invasion or metastasis ( χ2= 4. 559, P = 0. 033) , hepatic encephalopathy ( χ2= 25. 568, P < 0. 01) , melena ( χ2= 0. 842, P = 0. 04) , and heart failure ( P = 0. 003) , pulse rate ( Z =-2. 943, P = 0. 003) , CTP classification ( χ2= 12. 22, P = 0. 002) , CTP score ( Z =-2. 505, P = 0. 012) , MELD score ( t =-2. 395, P = 0. 018) , and GBS score ( Z =-2. 545, P = 0. 011) . There were significant differences between the 6-week death group and the survival group in the incidence rates of liver cancer ( χ2= 9. 374, P = 0. 002) , liver cancer with vascular invasion or metastasis ( χ2= 14. 766, P < 0. 01) , and hepatic encephalopathy ( χ2= 16. 327, P < 0. 01) , albumin ( Z =-2. 770, P = 0. 006) , bilirubin ( Z =-3. 191, P = 0. 001) , hemoglobin ( Z =-2. 484, P = 0. 013) , blood urea nitrogen ( Z =-2. 407, P = 0. 016) , international normalized ratio ( Z =-2. 304, P = 0. 021) , systolic pressure ( t = 2. 69, P = 0. 008) , pulse rate ( Z =-3. 507, P < 0. 01) , CTP classification ( χ2= 25. 851, P < 0. 01) , CTP score ( Z =-3. 591, P < 0. 01) , MELD score ( t =-4. 121, P < 0. 01) , and GBS score ( Z =-3. 54, P < 0. 01) . GBS score ( AUC = 0. 738, 95% confidence interval [CI]: 0. 67-0. 80) was superior to MELD score ( AUC = 0. 731, 95% CI: 0. 66-0. 79) and CTP score ( AUC = 0. 728, 95% CI:0. 66-0. 79) in predicting the risk of death at 1 week. MELD score ( AUC = 0. 761, 95% CI: 0. 70-0. 89) was superior to CTP score ( AUC = 0. 748, 95% CI: 0. 69-0. 81) and MELD score ( AUC = 0. 726, 95% CI: 0. 66-0. 79) in predicting the risk of death at 6 weeks.There was a significant difference in the AUC for predicting the death rate at 1 week between GBS score and CTP score ( Z = 0. 079, P =0. 037) , while there was no significant difference in the AUC for predicting the death rate at 6 weeks between the three scoring systems ( P> 0. 05) . Conclusion GBS score is superior to MELD score and CTP score in predicting the risk of death at 1 week in cirrhotic patients with esophagogastric variceal bleeding, and MELD and CTP scores are superior to GBS score in predicting the risk of death at 6 weeks.
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