Endoscopy 2018; 50(04): S134-S135
DOI: 10.1055/s-0038-1637432
ESGE Days 2018 ePoster Podium presentations
21.04.2018 – Variceal bleeding 2
Georg Thieme Verlag KG Stuttgart · New York

PREDICTIVE FACTORS FOR REBLEEDING IN VARICEAL UPPER GASTROINTESTINAL BLEEDING IN PATIENTS WITH LIVER CIRRHOSIS

I Groza
1   “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
,
M Acalovschi
1   “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
,
S Pasca
1   “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
,
B Procopet
1   “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
2   Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor Cluj-Napoca, Cluj-Napoca, Romania
,
H Stefanescu
2   Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor Cluj-Napoca, Cluj-Napoca, Romania
,
M Tantau
1   “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
2   Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor Cluj-Napoca, Cluj-Napoca, Romania
,
D Matei
1   “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
2   Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor Cluj-Napoca, Cluj-Napoca, Romania
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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    Aims:

    Upper gastrointestinal bleeding (UGIB) is one of the most frequent and severe gastroenterological emergencies. Rebleeding occurs in 50 – 80% of these patients, more than half of them occuring, during the first 6 weeks. The higher risk of rebleeding is known to be between 5 days and 6 weeks.

    The aim of the study was to identify the predictive factors for rebleeding in variceal upper gastrointestinal bleeding (UGIB) in cirrhotic patients.

    Methods:

    In the present study cirrhotic patients who presented for variceal UGIB to the emergency department of a tertiary hospital were enrolled over a period of 26 months. All patients were followed clinically (presence of ascites), biologically (platelets count, serum creatinine, albumin, total bilirubin and INR), and endoscopically (grade of esophageal varices and active bleeding at upper gastrointestinal endoscopy). The patients were divided into two groups based on rebleeding status: patients with and patients without rebleeding. Based on clinical and laboratory variables Child-Pugh class and the MELD score were also determined.

    Results:

    The study included 168 patients. Rebleeding was present in 16.7% of the cases.

    The following differences were noted by comparing patients with and without rebleeding: age 58.54 ± 15.7 vs. 58.81 ± 11.4 (p = 0.913); failure to control bleeding 32.14% vs. 5.71% (p < 0.001); ascites 75% vs. 73.51% (p = 1.000); platelets count (no./mm3) ≤140,000: 75% vs. 84.28% (p = 0.361); serum albumin (g/dL) (3.0 ± 0.6) vs. (3.1 ± 0.56) (p = 0.200); serum bilirubin (mg/dL) 2.7 (1.5; 5.45) vs. 2.05 (1.4; 3.97) (p = 0.295); INR (international normalized ratio) 1.97 (1.58; 2.22) vs. 1.61 (1.46; 1.9) (p = 0.011); Child-Pugh A: 17.85% vs. 20.71%, Child-Pugh B: 21.42% vs. 42.85%, Child-Pugh C: 60.71% vs. 36.42% (p = 0.045); MELD score: 18.21 ± 6.75 vs. 17.04 ± 5.93 (p = 0.353); active bleeding at the upper gastrointestinal endoscopy 17.85% vs. 22.14% (p = 0.801); grade of esophageal varices grade II 52% vs. 57.35%, grade III 40% vs. 36.76%, flattened 8% vs. 5.14% (p = 0.883).

    Conclusions:

    In the present study, rebleeding is shown to be significantly associated with failure to control bleeding, INR and Child-Pugh C class.


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