Abstract

MARTINEZ, Julián David et al. Prognostic Factors Associated with Mortality in Cirrhotic Patients with Bleeding Varices at Two Hospitals in Bogotá D.C. Colombia. Rev Col Gastroenterol [online]. 2016, vol.31, n.4, pp.331-336. ISSN 0120-9957.

Background: Ninety percent of cirrhotic patients will develop esophageal varices, and bleeding will occur in 30% of these patients at some point in their lives. Objective: The objective of this study was to identify prognostic factors associated with mortality in cirrhotic patients with bleeding varices. Method: We present a retrospective cohort study of patients with bleeding digestive varices over a period of 30 months. Results: This study included 63 patients (33 men and 30 women) whose average age was 56 years (SD: 16 years). 52.4% of these patients’ Child-Pugh classification was B. The average stay in the hospital was 10 days. Twelve (19%) died. Hypovolemic shock (p = 0.033) and red blood cell transfusion (p = 0.05) were related to mortality. Bivariate analysis showed that the variable most closely related to mortality was hepatic impairment with Child-Pugh C classification  (p = 0.00). Comparisons of numerical variables found that the creatinine value (Mean: 1.74 mg/dl, p = 0.043) and length of hospital stay (mean time:10 days, p = 0.057) were higher in patients who died. In the bivariate analysis, Child-Pugh C (Exp (B) = 0.068, p = 0.002) and creatinine (Exp (B) = 0.094, p = 0.034) remained statistically related to the outcome of interest. Conclusions: Mortality from bleeding varices in the patients in this study is comparable to current international standards. Because advanced liver disease and impaired renal function are associated with increased mortality, patients with bleeding varices who have predictors for mortality during decompensation due to bleeding warrant close monitoring and early interventions to avoid negative outcomes

Keywords : Hemorrhaging; digestive; varices; esophageal varices.

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