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    BASIC RESEARCH JOURNALS OF MEDICINE AND CLINICAL SCIENCE ISSN 2315-6864 ISI IF 0.836
 

Basic Research Journal of Medicine and Clinical Sciences ISSN 2315-6864 Vol. 7(1): Pp 01-10 March 2018

Copyright© 2017 Basic Research Journals

International Scientific Indexing lSI Impact Factor (0.836)

 

Full Length Research Paper

 

Predictive factors of failure to control bleeding and 6-week mortality after variceal hemorrhage in liver cirrhosis - a tertiary referral center experience

 

Daniela Matei2, *Dana Crisan3, Ioana Groza1, Bogdan Furnea1, Cristina Levi1, Bogdan Procopet2, Marcel Tantau2

 

1Regional Institute of Gastroenterology and Hepatology “Prof. dr. Octavian Fodor”, Cluj-Napoca

2Medical Clinic, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca

3Clinical Municipal Hospital, Cluj-Napoca

 

*Corresponding author email: crisan.dc@gmail.com

 

Received 16 March, 2018; Accepted 27 March, 2018; 02 April, 2018

 

Abstract

 

Background: Mortality from variceal bleeding remains high despite the therapeutic progress in severe cirrhosis. Understanding the predictive factors of failure to control bleeding (FTB) and mortality assumes better future therapies. Comorbidities are thought to be important prognostic factors for variceal bleeding. Aim: To assess the factors associated with FTB and with 42-day mortality and to evaluate the influence of comorbidities on these patients’ prognosis. Method: Patients with variceal bleeding admitted in a tertiary referral center were prospectively included in the study and followed over 6 weeks. CirCom score and Charlson index were used for the assessment of comorbidities. Results: Of the 138 patients included in the study, 27(19.5%) were considered to have FTB. Child C class (74.07% vs 32.43%, p<0.001), Meld score (20.5 vs 16.00, p=0.004) and creatinin level (1.04 vs 0.81, p=0.01) were associated with FTB, but only Child class was independently associated with FTB in multivariate analysis (OR=2.94, p=0.006). Mortality at 42 days (21.7%) was influenced by the severity of the dissease assessed through Child Class (76.66% vs 30.55%-Child C, p<0.001) and MELD score (21.00 vs 16.00, p<0.001). Creatinin level (1.00 vs 0.7, p=0.02) and acute kidney injury (26.66% vs 7.40%, p=0.009) were also prognostic factors for the 6-week mortality. Comorbidities didn’t influence the mortality (CirCom>1 (16.7% vs 21.3%, p=0.76) and Charlson index>4 (36% vs 47.2%, p=0.41). Conclusion: The severity of cirrhosis is an important prognostic factor for FTB and 42-day mortality. Identifying the factors associated with early mortality may help selecting patients needing more than conventional therapy.

 

Keywords: variceal bleeding, cirrhosis, failure to control bleeding, mortality, predictive factors

 

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Basic Research Journal of Business Management and Accounts.

 

Basic Research Journal of Education Research and Review.

Basic Research Journal of Agricultural Science and Review.

Basic Research Journal of Social and Political Sciences.

 

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