[Prognostic factors of early mortality in the 1st episode of hemorrhage caused by esophageal varices].
OBJECTIVE
To assess the prognostic factors of early mortality in cirrhotic patients with the first variceal bleeding episode.


METHODS
Fifty-five cirrhotic patients with endoscopic evidence of variceal bleeding treated with sclerotherapy during emergent endoscopy were included.


RESULTS
Permanent hemostasis was obtained in 36 patients (65.5%). Fourteen (25.4%) patients died within six weeks of the bleeding episode. Twenty-four variables obtained at admission and in the following days were compared between patients who survived (n = 41), and died (n = 14). In the univariate analysis the following variables were related to early mortality: prothrombin ratio (p = 0.04), the presence of ascites (p = 0.004) and encephalopathy (p = 0.06), albumin (p = 0.01), Child-Pugh score (p = 0.0003), hemostasis during endoscopy (p = 0.002), absence of rebleeding at 24 hours (p = 0.01) and early rebleeding (within five days after the bleeding episode) (p = 0.006). Multiple logistic regression identified the Child-Pugh score (OR 11.86, CI 95% 2.54-55.48; p = 0.001) and early rebleeding (OR 6.27, CI 95% 1.29-30.44; p = 0.02) as prognostic independent factors of early mortality.


CONCLUSIONS
The degree of hepatic failure and early rebleeding are prognostic independent factors of early mortality in cirrhotic patients after the first variceal bleeding episode.
Campo
R
R
Unidad de Endoscopia Digestiva (S.D.I), CH Parc Taulí, Sabadell, Barcelona.
Brullet
E
E
Montserrat
A
A
Calvet
X
X
Dalmau
B
B
Gil
M
M
Güell
J
J
Mas
P
P
D000704:Analysis of Variance; D004630:Emergencies; D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015911:Sclerotherapy
Factores predictivos de mortalidad precoz en el primer episodio hemorrágico por varices esofágicas.