Factors Predicting Mortality of Variceal Bleeding in Liver Cirrhosis

Journal of Nepal Medical Association

article

Amrendra Kumar Mandal¹  Mukesh Sharma Paudel¹  Sudhamshu KC²  Sitaram Chaudhary¹  Bidhan Nidhi Paudel¹  Nandu Silwal Poudyal¹  Barun Shrestha¹  Rajan Kanth³  Paritosh Kafle⁴ 

[1] Gastroenterology Unit, Department of Medicine, Bir Hospital, NAMS;Hepatology Unit, Department of Medicine, Bir Hospital, NAMS;Carilion Clinic;Interfaith Medical Center

关键词: acute variceal bleeding;    CTPscore;    MELD score;    serum creatinine.;   

DOI  :  10.31729/jnma.3408

学科分类：社会科学、人文和艺术（综合）

来源: Nepal Medical Association since

【 摘 要 】

Introduction: Acute variceal bleeding in liver cirrhosis is an immediate life-threatening condition and amajor complication of portal hypertension associated with higher morbidity, mortality and hospital costs than any other causes of UGI bleeding. Therefore, early stratification and initiation of therapy based on several factors can reduce mortality associated with it. We aimed to study the predictors of mortality in acute variceal bleeding in LC. Methods: An observational prospective study was conducted in Gastroenterology and Hepatology units of Bir Hospital, Kathmandu, Nepal from April 1, 2016 to May 30, 2017. Patients were included if they had underlying liver cirrhosis and presented upper GI bleeding which were proven to be secondary to variceal bleeding. Results: Seventy-five patients with mean age of 52.5 years were available or the analysis. The M:F ratio was 2.1:1. There were 66 patients in mortality group and 9 in survivor group. The mean CTP and MELD score were 10.17±1.66 and 20.40±8.29 respectively. Among the predictors of the mortality studied, CTP score, MELD score, mean arterial pressure, Serum bilirubin, serum creatinine, need of FFP as well as PRP transfusion, presence of hepatorenal syndrome and hepatic encephalopathy were high in mortality group with statistical significance. On multivariate analysis, high CTP and high serum creatinine level were only significant predictors of mortality. Receiver operating curve for predicting accuracy of mortality was significant with higher MELD and higher CTP score. Conclusions: Strong predictors of mortality in patients with cirrhosis presenting with variceal bleeding are CTP score and high serum creatinine level.

【 授权许可】

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