Dr. Marwa El Fayoumy
National Liver Institute-Menoufia University
Title: Multivariate Analysis of Risk Factors for Mortality in Acute ‎Variceal Bleeding.‎
Biography
Biography: Dr. Marwa El Fayoumy
Abstract
Acute variceal bleeding in liver cirrhosis is an immediate life-threatening condition and a major complication of portal hypertension. We aimed to study the predictors of mortality in acute variceal bleeding in cirrhotic patients.We prospectively evaluated 703 consecutive patients admitted with endoscopically proven acute variceal hemorrhage (71.4% males, mean age 58 ± 10.3 years), 43% admitted with first attack of hematemesis, 14.1% Child-Turcotte-Pugh (CTP) A, 47.2% CTP B, 38.7% CTP C, 38.3% had HCC. All patients received antibiotics and vasoactive drugs. Endoscopic treatment was individualized. The outcome was the 6-week mortality. Bleeding was controlled in 422 patients (59.9%) and 210 patients died (29.8%), (122 (17.4%) during hospitalization, 69 patients from causes not related to the acute hemorrhage (9.8%)). Rebleeding occurred in 281 patients (39.9%) after the first week.Disease severity scores (platelet-albumin-bilirubin (P-ALBI), ALBI, MELD, IMELD, MELD-Na, and UMELD) and bleeding risk scores (GB score, admission Recall, AIMS 65 and APASL score) were calculated on admission and the full Recall score following endoscopy. Demographic, clinical and laboratory data and the calculated scores were compared between survivors and non-survivors