Predictive Value of the Combination of Lactate and qSOFA Score for Clinical Outcomes in Cirrhotic Patients with Esophagogastric Variceal Bleeding

Purpose: The objective of our research was to examine the predictive power of the combination of lactate and the quick Sepsis-Related Organ Failure Assessment (qSOFA) score on clinical outcomes in cirrhotic patients with EGVB. Patients and Methods: This single-center retrospective study consecutively enrolled 547 eligible cirrhotic patients with EGVB admitted to the Emergency Department of Beijing You’an Hospital between July 2022 and November 2022. Data collected included Lactate levels, qSOFA, pre-endoscopic Rockall score (pRS), Glasgow-Blatchford score (GBS), albumin, international normalized ratio (INR), altered mental status, systolic blood pressure, age older than 65 years score (AIMS65), and age, blood tests, comorbidities scores (ABC). These variables were used to predict rebleeding, ICU-admission, and 6-week mortality. Receiver operating characteristic (ROC) curves and logistic regression analysis were used to assess the prognostic value of the scoring systems. Results: Lactate and qSOFA independently predicted ICU admission and 6-week mortality (P< 0.05). qSOFA alone was an independent predictor of rebleeding, but lactate was not. For rebleeding prediction, the AUC values were: pRS 0.540, GBS 0.582, AIMS65 0.519, ABC 0.510, and Lac+qSOFA 0.564. For ICU-admission, the AUC values were: pRS 0.723, GBS 0.623, AIMS65 0.787, ABC 0.760, and Lac+qSOFA 0.808. For 6-week mortality, the AUC values were: pRS 0.759, GBS 0.715, AIMS65 0.817, ABC 0.834, and Lac+qSOFA 0.818. The combination of lactate and qSOFA showed better predictive performance for ICU admission and 6-week mortality than for rebleeding. Conclusion: Although the combination of lactate and qSOFA offers limited utility for predicting rebleeding, it is a robust predictor of ICU admission and 6-week mortality in cirrhotic patients with EGVB. Its simplicity and rapid availability make it a highly practical tool for emergency triage in this high-risk population. Keywords: cirrhosis, esophagogastric variceal bleeding, lactate, qSOFA score, mortality