title: [Natural history of gastric varices and risk factors for bleeding].
abstract: OBJECTIVE
  Gastric varices (GV) are one of the most serious complications of portal hypertension, but there is limited information on the clinical course of GV in Korea. The aim of this study was to elucidate the natural history of GV bleeding in Korean patients.
  
  
  METHODS
  Of 604 patients with GV diagnosed between May 1995 and May 2005 at the Samsung Medical Center, 237 patients without a history of variceal bleeding or previous intervention for varices were investigated. The cumulative incidence rates of GV bleeding, long-term survival rates, and risk factors for GV bleeding were evaluated.
  
  
  RESULTS
  The cumulative incidence rates of GV bleeding were 4.8%, 19.9%, and 23.2% at 1, 3, and 5 years after diagnosis, respectively. The overall survival rates were 88.6%, 53.2%, and 37.2% at 1, 5, and 10 years. In the univariate analysis, fundal varices, large (F3) GV, red color sign, and poor liver function (Child-Pugh class B or C) were significant risk factors for GV bleeding. In the multivariate analysis, large GV (hazard ratio 2.49) and poor liver function (hazard ratio 3.95) were the independent risk factors.
  
  
  CONCLUSIONS
  GV bleeding was more frequent in patients with fundal varices than in patients with type 1 gastroesophageal varices, and large GV and poor liver function were risk factors for GV bleeding. Close observation and prophylaxis for variceal bleeding might be warranted in high-risk patients.
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Choong Hyeon
authors.initials: CH
authors.lastname: Lee
authors.forename: Joon Hyoek
authors.initials: JH
authors.lastname: Lee
authors.forename: Yong Sung
authors.initials: YS
authors.lastname: Choi
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Paik
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Sinn
authors.forename: Choon Young
authors.initials: CY
authors.lastname: Lee
authors.forename: Kwang Cheol
authors.initials: KC
authors.lastname: Koh
authors.forename: Geum-Youn
authors.initials: GY
authors.lastname: Gwak
authors.forename: Moon Seok
authors.initials: MS
authors.lastname: Choi
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Yoo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011859:Radiography; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors