Risk factors for early rebleeding after elective endoscopic variceal ligation(EVL) and long-term outcome: a retrospective analysis
10.3760/cma.j.issn.1007-5232.2013.12.003
- VernacularTitle:食管静脉曲张择期内镜下套扎术后早期再出血及远期预后的回顾性分析
- Author:
Zhu WANG
;
Xuefeng LUO
;
Xiao LI
- Publication Type:Journal Article
- Keywords:
Liver cirrhosis;
Esophageal varices;
Rebleeding;
Endoscopic variceal ligation
- From:
Chinese Journal of Digestive Endoscopy
2013;30(12):668-670
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the risk factors for early rebleeding (ERB) after elective endoscopic variceal ligation (EVL) in cirrhotic patients and the influence of ERB on the long-term survival.Methods A total of 198 cirrhotic patients who received elective EVL were retrospectively evaluated.Twenty-six patients rebleeded within 6 weeks after initial EVL and were assigned to the ERB group.One hundred and seventy-two other cirrhotic patients were assigned to the control group.Multivariate analysis was used to define the high risk factors of ERB.A Kaplan-Meier analysis was performed to evaluate the cumulative survival rates between two groups.Results The Child-Pugh classification (P =0.016),Child-Pugh scores (P=0.012),and the total bilirubin (P =0.001) were significantly different between ERB and control group.Multivariate analysis showed total bilirubin was the only independent risk factor of ERB (OR =2.02,95％CI:1.04-4.04,P =0.008).The proportional mortality indicator of bleeding-related deaths was 66.7％ (10/15) in ERB group and 13.6％ (6/44) in control group (P ＜0.01).The five-year curmulative survival rate of the control-group was significantly higher than that of the rebleeding group (67.8％ vs.25.3％,P ＜ 0.01).Conclusion Cirrhotic patients with ERB after elective EVL have a poor prognosis.High level of total bilirubin may predict ERB.
