Long-term prognosis of patients with cirrhosis of the liver and upper gastrointestinal bleeding.
A study has been carried out on the 5-yr survival curves of 287 patients admitted with upper gastrointestinal bleeding and portal hypertension. In 78.7%, the cause of bleeding was from esophageal varices. Only 2.4% had noncirrhotic portal hypertension, and 80% were alcoholics. At 5 yr, the overall survival probability was 26.2%. The curve had three segments with survival rates of 69% at 2 wk and 46.6% at 12 months. According to Child's grade, the curves were very different at 2 wk, 12 months, and 60 months: Group A, 94.0, 78.0, and 51.8%; group B, 77.0, 46.0, and 32.2; group C, 52.0, 11.0, and 2.3%. The largest differences were observed in the first 2 wk immediately after the first bleeding. The recurrence of bleeding in a period of 6 months significantly decreased the survival. Age, as well as the introduction of prophylactic measures (propranolol or sclerotherapy), did not influence long-term survival. Alcohol abstinence was accompanied by better survival. This difference was due to the impact of abstinence only in group B patients.
Pinto
H C
HC
Department of Medicine 2, University Hospital of Santa Maria, Lisbon, Portugal.
Abrantes
A
A
Esteves
A V
AV
Almeida
H
H
Correia
J P
JP
D000367:Age Factors; D004932:Esophageal and Gastric Varices / Q000209:etiology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012008:Recurrence; D012746:Sexual Abstinence; D016019:Survival Analysis; D013997:Time Factors