title: Factors determining the clinical outcome of acute variceal bleed in cirrhotic patients.
abstract: Variceal bleed is a severe complication of portal hypertension. We studied the predictors of failure to control variceal bleed and re-bleed in patients with cirrhosis. We reviewed the case records of 382 consecutive patients admitted with variceal bleed from January 2001 to December 2005. Diagnosis of cirrhosis was made on clinical, laboratory, and radiological parameters. Acute variceal bleeding, failure to control bleed, and re-bleeding were defined according to Baveno III consensus report. Failure to control bleed was observed in 39 (10.2%) patients while in hospital re-bleed occurred in 49 (12.8%) patients. Thirty-four patients died. Diabetes was present in 148 (39%) patients. On multivariate logistic regression analysis, predictors of failure to control bleed were presence of diabetes mellitus and active bleeding at the time of endoscopy; predictors of in-hospital re-bleed were diabetes mellitus and serum bilirubin >3 mg/dL. Diabetes mellitus, active bleeding at endoscopy and bilirubin >3 mg/dL are bad prognostic factors for initial control of variceal bleed, and recurrent bleed in patients with cirrhosis.
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Shahid
authors.initials: S
authors.lastname: Majid
authors.forename: Zahid
authors.initials: Z
authors.lastname: Azam
authors.forename: Hasnain Ali
authors.initials: HA
authors.lastname: Shah
authors.forename: Mohammad
authors.initials: M
authors.lastname: Salih
authors.forename: Saeed
authors.initials: S
authors.lastname: Hamid
authors.forename: Shahab
authors.initials: S
authors.lastname: Abid
authors.forename: Wasim
authors.initials: W
authors.lastname: Jafri
mesh_terms: D000208:Acute Disease; D048909:Diabetes Complications; D004659:Enbucrilate / Q000008:administration & dosage; D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000628:therapy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic; D006489:Hemostatic Techniques; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D011379:Prognosis; D012008:Recurrence; D015911:Sclerotherapy
chemical_list: D004659:Enbucrilate