Prediction of oesophageal variceal bleeding

Abstract

Objective: To evaluate the prediction of variceal bleeding by the Beppu (Japanese Research Society for Portal Hypertension) and NIEC (North Italian Endoscopie Club) scores in groups of patients with different investigators. Methods: A total of 200 patients with liver cirrhosis and endoscopically proven oesophageal varices, but without any previous gastrointestinal bleeding, were enrolled and followed up for 12 months. Results: Overall, 191 patients were evaluated. The Beppu score classified patients into categories of bleeding risk (P=0.0055), but the actual bleeding rates were significantly different from those predicted by the score (P< 0.001 ). The Beppu score overestimated the risk of variceal bleeding, particularly for high-risk groups. The NIEC score also classified patients according to bleeding risk (P= 0.0260), but the expected and observed cumulative bleeding rates were not significantly different for any group (P=0.123). This score was more accurate, although it overestimated bleeding risk by a factor of 2.4, on average. Conclusion: Our data confirm that the Beppu and NIEC scores can identify groups of patients at risk of variceal bleeding. However, the latter's prediction of risk is closer to the actual bleeding rate, despite some overestimation.