PROGNOSTIC MARKERS FOR ACUTE VARICEAL BLEED IN PATIENTS WITH CIRRHOSIS OF LIVER AND PORTAL HYPERTENSION
Anoop K. Koshy*, Bilal Mohmed, Harshavardhan B. Rao, Priya Nair and Krishna Priya
ABSTRACT
Background and Aims: Variceal bleed is the most lethal complication of liver cirrhosis. Several factors and scoring systems have been known to predict the outcome of variceal bleed. The aim of the study was to assess the efficacy of current known factors and prognostic scoring systems in predicting short term outcome in patients presenting with variceal bleeding. Materials and Methods: The study was a prospective observational study that included 127 adult patients with cirrhosis and portal hypertension who presented with variceal bleeding. The outcomes measured were mortality and length of hospital stay (= 7 days or > 7 days). A poor outcome was taken as mortality or hospital stay > 7 days. Categorical variables were expressed using frequency and percentage. Numerical variables were presented using mean and standard deviation. Chi-square test with continuity correction was used to study the statistical significance of the association of all categorical variables with the outcomes mortality and hospital stay. Student’s t test was used to study the statistical significance of the comparison of all continuous demographic and clinical parameters between outcomes. Results and Conclusion: The study showed that total counts, platelet counts, INR did not have significant association with poor outcomes. Presence of hepatic encephalopathy, renal failure and a MELD score >/= 14 were found to have association with mortality in variceal bleed. CHILD C status, presence of hepatic encephalopathy, MELD score >/= 14, AIMS 65 score of >/=2 and Glasgow Blatchford Score (GB score) >8 were predictors of a prolonged hospital stay.
Keywords: Cirrhosis, variceal bleed, prognostic markers.
[Full Text Article]
[Download Certificate]