TITLE:
Predictors of early rebleeding and mortality after acute variceal haemorrhage in patients with cirrhosis
AUTHORS:
Iliass Charif, Kaoutar Saada, Ihsane Mellouki, Mounia El Yousfi, Dafr Allah Benajah, Mohamed El Abkari, Adil Ibrahimi, Nourdin Aqodad
KEYWORDS:
Cirrhosis; Portal Hypertension; Gastrointestinal Bleeding; Esophageal Varices
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.3 No.7,
November
26,
2013
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.