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Combined PAR and Charlson Comorbidity Index for Predicting Risk after EVL in Cirrhotic Patients with EVB Due to Liver Cirrhosis
1.Yancheng Clinical School of Xuzhou Medical University， Jiangsu Yancheng 224000， China；
2.Binhai County People's Hospital， Jiangsu Yancheng 224500， China；
.YanCheng First People's Hospital， Jiangsu Yancheng 224000， China
Received date: 2025-08-29
Revised date: 2025-09-16
Accepted date: 2025-12-24
Online published: 2026-04-21
Objective： To analyze the value of platelet-to-albumin ratio （PAR） combined with Charlson comorbidity index in evaluating rebleeding risk after ligation of esophageal variceal bleeding （EVB） due to liver cirrhosis.Methods： 103 patients with EVB due to liver cirrhosis underwent endoscopic variceal ligation （EVL） in our hospital between May 2021 and June 2024. They were followed up for 6 months after ligation， and were divided into rebleeding group and non-rebleeding group according to whether there was rebleeding. Clinical data such as PAR and Charlson index at admission were compared between groups. Logistic regression analysis was conducted to screen the risk factors for rebleeding in patients with EVB due to liver cirrhosis after EVL. The receiver operating characteristic curve （ROC） was used to analyze the value of PAR combined with Charlson index in evaluating rebleeding.Results： 36 cases （34.9%） experienced rebleeding at 6 months after successful hemostasis through EVL， and 1 of them died within 72 h after the occurrence of bleeding. Platelet count （PLT） and PAR in the rebleeding group were lower than those in the non-rebleeding group （P<0.05）. The levels of total bilirubin （TBIL）， alanine aminotransferase （ALT） and D-dimer （D-D）， Charlson index， hepatic venous pressure gradient， portal vein diameter， splenic vein diameter， splenic thickness， the proportions of Child-Pugh grade C， ascites， endoscopic red sign and grade G3 varicose veins in the rebleeding group were， significantly higher than those in the non-rebleeding group （P<0.05）. Prothrombin time in the rebleeding group was longer than that in the non-rebleeding group （P<0.05）. Binary logistic regression analysis showed that PAR was protective factor for postoperative rebleeding in patients with EVB due to liver cirrhosis ［OR=0.550， 95%CI： 0.391-0.773， P<0.05］，while hepatic venous pressure gradient， grade of varicose veins， and Charlson index were independent risk factors （OR： 1.621， 95%CI： 1.076-2.442； OR： 1.459， 95%CI： 1.075-1.981； OR： 1.644， 95%CI： 1.058-2.555， P<0.05）. ROC showed that the area under the curve of PAR combined with Charlson index for predicting rebleeding was 0.878， greater than that of PAR and that of Charlson index （0.798， 0.788， P<0.05）.Conclusion： The combination of PAR and Charlson index demonstrates high value in predicting rebleeding in patients with EVB due to liver cirrhosis after EVL. It is worthy of clinical promotion and application. Necessary intervention measures should be carried out.
PAN Weiwei, ZHAO Chengli, ZHANG Miao, MENG Hai, JIANG Zhonghua
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Combined PAR and Charlson Comorbidity Index for
Predicting Risk after EVL in Cirrhotic Patients with EVB Due to Liver Cirrhosis
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