title: Risk factors for predicting early variceal rebleeding after endoscopic variceal ligation.
abstract: OBJECTIVE
  To analyze the clinical risk factors for early variceal rebleeding after endoscopic variceal ligation (EVL).
  
  
  METHODS
  342 cirrhotic patients with esophageal varices who received elective EVL to prevent bleeding or rebleeding at our endoscopy center between January 2005 and July 2010. were included in this study. The early rebleeding cases after EVL were confirmed by clinical signs or endoscopy. A case-control study was performed comparing the patients presenting with early rebleeding with those without this complication.
  
  
  RESULTS
  The incidence of early rebleeding after EVL was 7.60%, and the morbidity of rebleeding was 26.9%. Stepwise multivariate logistic regression analysis showed that four variables were independent risk factors for early rebleeding: moderate to excessive ascites [odds ratio (OR) 62.83, 95% CI: 9.39-420.56, P < 0.001], the number of bands placed (OR 17.36, 95% CI: 4.00-75.34, P < 0.001), the extent of varices (OR 15.41, 95% CI: 2.84-83.52, P = 0.002) and prothrombin time (PT) > 18 s (OR 11.35, 95% CI: 1.93-66.70, P = 0.007).
  
  
  CONCLUSIONS
  The early rebleeding rate after EVL is mainly affected by the volume of ascites, number of rubber bands used to ligate, severity of varices and prolonged PT. Effective measures for prevention and treatment should be adopted before and after EVL.
authors.affiliation: Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Xu
authors.forename: Feng
authors.initials: F
authors.lastname: Ji
authors.forename: Qin-Wei
authors.initials: QW
authors.lastname: Xu
authors.forename: Mie-Qing
authors.initials: MQ
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004724:Endoscopy / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000150:complications*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008026:Ligation / Q000379:methods*; D008297:Male; D012307:Risk Factors; D055502:Secondary Prevention; D016896:Treatment Outcome; D055815:Young Adult