Association of Variceal Bleeding with Mortality Risk in Cirrhotic Patients Using the MELD Score

Original Article

Abstract

Objective: To determine the association between variceal bleeding and mortality risk among patients with cirrhosis and to evaluate the relationship between MELD score and mortality outcomes.

Methodology: This cross-sectional study Was Conducted in the General Medicine Department, Bolan Medical College/Hospital, Quetta. From April 2025 to September 2025, 213 patients diagnosed with cirrhosis were included. We evaluated patients' demographic characteristics, clinical presentation, presence or absence of variceal bleeding, laboratory parameters, MELD score, and clinical outcome. Patients were categorized according to variceal bleeding status and mortality outcome. We assessed the association between MELD score, variceal bleeding, and mortality using appropriate statistical tests. We considered p <0.05 statistically significant.

Results: The study included 213 patients with liver cirrhosis. The mean age was 53.6 ± 11.8 years, with 139 (65.3%) males and 74 (34.7%) females. Variceal bleeding was present in 96 (45.1%) patients, while 117 (54.9%) had no variceal bleeding. Overall, 47 (22.1%) patients died, and 166 (77.9%) survived. The mean MELD score was 18.7 ± 7.2. Among patients with variceal bleeding, 34 (35.4%) died compared with 13 (11.1%) patients without variceal bleeding. Mortality was significantly higher among patients with variceal bleeding (χ²=20.14, p<0.001). Survivors had a lower mean MELD score than non-survivors, while higher MELD scores were associated with increased mortality risk. These findings indicate that both variceal bleeding and MELD score were important factors associated with mortality.

Conclusion: Variceal bleeding represents an important clinical complication among patients with cirrhosis and may be associated with increased mortality risk. The MELD score provides an objective assessment of hepatic disease severity and can help identify patients at greater risk of adverse outcomes. Early recognition of high-risk patients, timely management of variceal bleeding, and appropriate monitoring of disease severity may improve clinical decision-making and patient outcomes.