[In-hospital mortality of acute hemorrhage of esophageal/fundus varices: an analysis of blood glucose level and other risk factors in 99 consecutive patients].
OBJECTIVE
The analysis of risk factors in acute variceal bleeding may help to optimize patient management. The influence of hyperglycemia, which has been demonstrated for different diseases in the intensive care unit, has not been investigated for acute variceal bleeding.


METHODS
We reviewed a consecutive series of 99 patients with acute variceal bleeding treated in our clinic between 1996 and 2005. Possible risk factors leading to death during the hospital stay were analysed.


RESULTS
The in-hospital mortality was increased in patients with a raised Child-Pugh index of cirrhosis, active bleeding during emergency endoscopy and an elevated creatinine concentration. The baseline blood glucose value was of no prognostic value.


CONCLUSIONS
Even in the current management of variceal bleeding the Child-Pugh index for cirrhosis as well as and active bleeding during emergency endoscopy remain decisive factors in the short-term prognosis. In contrast to other diseases occurring in the intensive care unit, hyperglycemia or insulin resistance plays no significant role.
Weickert
U
U
Medizinische Klinik C, Klinikum der Stadt Ludwigshafen gGmbH. uwe.weickert@slk-kliniken.de
Teichmann
J
J
Eickhoff
A
A
Hartmann
D
D
Riemann
J F
JF
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D003404:Creatinine / Q000097:blood*; D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000401:mortality; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000401:mortality*; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
D001786:Blood Glucose; D003404:Creatinine