Prognostic indicators in cirrhotic patients with bleeeding oesophageal varices
Other Title(s)
المؤشرات التقديرية لما يحتمل أن يحدث لمرضى تليف الكبد القادمين بنزيف دوالي حاد
Joint Authors
al-Attar, Madihah Muhammad
Suwayfi, Yusuf Muhammad
Ayyad, Eiriny E.
Ahmad, Ahlam Muhammad
Source
Issue
Vol. 27, Issue 1 (31 Jan. 2003), pp.53-62, 10 p.
Publisher
Assiut University Faculty of Medicine
Publication Date
2003-01-31
Country of Publication
Egypt
No. of Pages
10
Main Subjects
Topics
Abstract EN
Bleeding oesophageal varices is an important came of morbidity and mortality in cirrhotic patients.
The aim of this study is to identify the risk factors that affect the prognosis in patients with liver cirrhosis presented with acute variceal bleeding through clinical and laboratory assessment.
This study included 200 cirrhotic patients who presented with bleeding oesophageal varices with mean age of 48.9 ± 11 A.years.
They were enrolled in prospective study and followedfor 6 weeks after the attack of bleeding .Patients were assessed using clinical, ultrasonographic, endoscopic and laboratory examinations.
Results: Hematemesis was controlled by vasoactive drugs in 132 cases (66%) while 68 cases (34%) continued to bleed and responded to balloon tamponade in (9.5%), sclerotherapy in (6%) and combinedprocedures in 18.5%.
Univariant analysis revealed that hepatic encephalopathy (p=0.001), malignant hepatic focal lesions on top of liver cirrhosis (P=0.013), ascites (P=0.000), albumin (P=0.000), bilirubin (P=0.01), prothrombin time (p= 0.001) and serum creatinine (P=0.000) were significantly affecting the survival.
.However, using logistic multivariant regression analysis for all variables revealed that three of seven variables significantly influenced the survival including the presence of hepatic focal lesion on top of liver cirrhosis (P=0.030), ascites (P=0.018) and prothrombin time (P=0.046) .
Total deaths within the first six weeks of index bleeding were 23 patients (11.5%).
Five of them (21.7%) died due to variceal bleeding, 9 patients (39.17 %) died due to liver cell failure, 6 patients (26%) died due to both liver cell failure and variceal bleeding and 3 patients (13%) died due to hepatorenal syndrome .The bleeding was higher in patients with Child grade C than B and A.
Non of the patients with Child A died after variceal bleeding, while the mortality rate in grade B was 3% and in grade C8.5%.
We conclude that the main factors that can independently affect the prognosis of cirrhotic patients with bleeding oesophageal varices are ascites, hepatocellular carcinoma on top of liver cirrhosis and prothrombin time.
Furthermore Child Pugh grade is an important prognostic factor
American Psychological Association (APA)
Suwayfi, Yusuf Muhammad& al-Attar, Madihah Muhammad& Ayyad, Eiriny E.& Ahmad, Ahlam Muhammad. 2003. Prognostic indicators in cirrhotic patients with bleeeding oesophageal varices. Assiut Medical Journal،Vol. 27, no. 1, pp.53-62.
https://search.emarefa.net/detail/BIM-54641
Modern Language Association (MLA)
Suwayfi, Yusuf Muhammad…[et al.]. Prognostic indicators in cirrhotic patients with bleeeding oesophageal varices. Assiut Medical Journal Vol.27, No.1(January, 2003), pp.53-62.
https://search.emarefa.net/detail/BIM-54641
American Medical Association (AMA)
Suwayfi, Yusuf Muhammad& al-Attar, Madihah Muhammad& Ayyad, Eiriny E.& Ahmad, Ahlam Muhammad. Prognostic indicators in cirrhotic patients with bleeeding oesophageal varices. Assiut Medical Journal. 2003. Vol. 27, no. 1, pp.53-62.
https://search.emarefa.net/detail/BIM-54641
Data Type
Journal Articles
Language
English
Notes
Text in English, abstracts in Arabic & English
Record ID
BIM-54641