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Factors determining the clinical outcome of acute variceal bleed in cirrhotic patients

  • Shahid Majid
  • Zahid Azam
  • Hasnain Ali ShahEmail author
  • Mohammad Salih
  • Saeed Hamid
  • Shahab Abid
  • Wasim Jafri
Short Report

Abstract

Variceal bleed is a severe complication of portal hypertension. We studied the predictors of failure to control variceal bleed and re-bleed in patients with cirrhosis. We reviewed the case records of 382 consecutive patients admitted with variceal bleed from January 2001 to December 2005. Diagnosis of cirrhosis was made on clinical, laboratory, and radiological parameters. Acute variceal bleeding, failure to control bleed, and re-bleeding were defined according to Baveno III consensus report. Failure to control bleed was observed in 39 (10.2%) patients while in hospital re-bleed occurred in 49 (12.8%) patients. Thirty-four patients died. Diabetes was present in 148 (39%) patients. On multivariate logistic regression analysis, predictors of failure to control bleed were presence of diabetes mellitus and active bleeding at the time of endoscopy; predictors of in-hospital re-bleed were diabetes mellitus and serum bilirubin >3 mg/dL. Diabetes mellitus, active bleeding at endoscopy and bilirubin >3 mg/dL are bad prognostic factors for initial control of variceal bleed, and recurrent bleed in patients with cirrhosis.

Keywords

Diabetes mellitus Gastric varix Gastro-intestinal hemorrhage Portal hypertension 

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Copyright information

© Indian Society of Gastroenterology 2009

Authors and Affiliations

  • Shahid Majid
    • 1
  • Zahid Azam
    • 1
  • Hasnain Ali Shah
    • 1
    Email author
  • Mohammad Salih
    • 1
  • Saeed Hamid
    • 1
  • Shahab Abid
    • 1
  • Wasim Jafri
    • 1
  1. 1.Section of Gastroenterology, Department of MedicineThe Aga Khan University HospitalKarachiPakistan

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