Article Abstract

Risk factors for 5-day bleeding after endoscopic treatments for gastroesophageal varices in liver cirrhosis

Authors: Rui Sun, Xingshun Qi, Deli Zou, Xiaodong Shao, Hongyu Li, Xiaozhong Guo

Abstract

Background: Endoscopic treatment is the mainstay treatment option for gastroesophageal varices. A retrospective study was performed to evaluate the risk factors for 5-day bleeding after endoscopic treatments for gastroesophageal varices in liver cirrhosis.
Methods: All cirrhotic patients who were consecutively admitted to our department between January and March 2016 and underwent endoscopic treatments for gastroesophageal varices were considered in this study. 5-day bleeding after endoscopic treatments was identified. Receiver operating curve (ROC) analysis was performed to calculate the diagnostic accuracy of baseline factors for predicting the occurrence of 5-day bleeding after endoscopic treatments. The area under curve (AUC) with 95% confidence interval (CI) was calculated.
Results: Overall, 95 patients were included. Eight (8.6%) patients developed 5-day bleeding after endoscopic treatments. Patients who developed 5-day bleeding after endoscopic treatments had significantly longer duration of hospitalizations and higher in-hospital mortality than those who did not develop. Five-day bleeding was significantly associated with lower albumin levels and higher prothrombin time, INR, and D-dimer level at baseline. In the ROC analysis, the AUC of albumin level for predicting the risk of being free of 5-day bleeding was 0.750 (95% CI: 0.571–0.929, P=0.020), and the AUCs of prothrombin time, INR, and D-dimer level for predicting the risk of 5-day bleeding were 0.850 (95% CI: 0.761–0.939, P=0.001), 0.790 (95% CI: 0.661–0.918, P=0.007), and 0.833 (95% CI: 0.729–0.938, P=0.002).
Conclusions: Albumin, prothrombin time, INR, and D-dimer level should be significant risk factors for 5-day bleeding after endoscopic treatments for gastroesophageal varices in liver cirrhosis.

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