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Predictors of early rebleeding and mortality after acute variceal haemorrhage in patients with cirrhosis
Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
- 1 Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
- 2 Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
- 3 Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
- 4 Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
- 5 Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
- 6 Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
- 7 Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
- 8 Department of Hepatology and Gastroenterology, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University of Fez, Fez, Morocco
Open Journal of Gastroenterology·Volume 03 (2013)·Pages 317–321·Published 26 November 2013·DOI10.4236/ojgas.2013.37056
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Abstract
The upper gastrointestinal bleeding from esophageal or gastric varices is the most dangerous complication of portal hypertension. The purpose of this study was to identify the predictors of early rebleeding and mortality after a bleeding episode. Patients and Methods: It was a retrospective study including 215 patients admitted in our department of hepatology and gastroenterology at the Hassan II University Hospital of Fez, from January 2001 to January 2010. Results: The mean age of our patients was 51 years. Thirty percent of patients had cirrhosis due to virus (B or C). The majority of patients (79%) had only esophageal varices. Fifty patients (23%) had a bleeding recurrence. Twenty-five patients (11.5%) died during the first ten days, of which 52% had presented rebleeding (p = 0.01). In 30% of cases, the rebleeding was secondary to a fall of pressure ulcers. Univariate analysis showed that early mortality of patients was significantly associated with advanced age (p = 0.018), low prothrombin time (PT) (p = 0.022), low serum sodium (p = 0.03), low platelet count (p = 0.05), and elevated transaminases (p = 0.02). Conclusion: The survival of cirrhotic patients after a bleeding episode was influenced by advanced age, a low rate of PT, of serum sodium, and of the platelet count, and elevated transaminases.
KeywordsCirrhosisPortal HypertensionGastrointestinal BleedingEsophageal Varices
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