PROSPECTIVE VALIDATION OF ADJUSTED BLOOD REQUIREMENT INDEX FOR PREDICTING TREATMENT FAILRUE OF ACUTE VARICEAL BLEEDING

Background: Acute variceal bleeding is one of the most serious complications in liver cirrhosis patients with high risk of mortality. Baveno Consensus Workshops IV identified an independent factor, Adjusted Blood Requirement Index (ABRI). ABRI value of ≥0.75 at any point time was defined as a failure to control variceal bleeding. However, there are few studies to validate clinical value of ABRI in patients with acute variceal bleeding. The present study aimed to determine the correlation of ABRI with 5th day bleeding control failure in patients with acute variceal bleeding. Methods: All consecutive patients presenting with variceal bleeding were prospectively recruited from April 2008 to Feburary 2011. Endoscopic intervention either band ligation or endoscopic variceal obturation was performed in cased with evidence of bleeding from varices on endoscopy. ABRI scores were calculated using the formula [ABRI = blood units transfused/[(final hematocrit-initial hematocrit)+0.01]. Definitions of treatment failures were defined according to Baveno IV criteria except ABRI. We validated the predictability of ABRI with treatment failure defined in Baveno IV.