Diabetes is associated with an increased risk of in-hospital mortality in liver cirrhosis with acute upper gastrointestinal bleeding

Background and Aims. Acute upper gastrointestinal bleeding (AUGIB) is a lethal complication of liver cirrhosis. We aimed to compare the outcomes of patients with liver cirrhosis and AUGIB who were admitted to hospital on regular hours and off-hours. Methods. This retrospective study screened all cirrhotic patients with AUGIB who were admitted to our hospital from January 2010 to June 2014 for the test cohort and from December 2014 to March 2018 for the validation cohort. A 1:1 propensity score matching analysis was performed to adjust the Child-Pugh and MELD scores. In-hospital mortality, 5-day rebleeding rate, length of stay, and total payment were primary outcomes. Results. Overall, 826 and 173 patients with liver cirrhosis and AUGIB were included in the test and validation cohorts, respectively. After propensity score matching, 226 and 40 patients were included in the test and validation cohorts, respectively. The overall analysis of the test cohort found significantly higher Child-Pugh score (P=0.006), 5-day rebleeding rate (18.69% versus 10.72%, P=0.001), and total payment (¥25,906.83 versus ¥22,017.42, P<0.001) in patients admitted on off-hours. By contrast, the overall analysis of the validation cohort did not find any difference in Child-Pugh score, 5-day rebleeding, in-hospital mortality, length of stay, or hospital payment between patients admitted on regular hours and off-hours. Similarly, the propensity score matching analyses of both test and validation cohorts found no difference in these primary outcomes between the two groups. Conclusions. Off-hours admission might not be negatively associated with the outcomes of patients with liver cirrhosis and AUGIB.

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Nonvariceal upper gastrointestinal bleeding in patients with liver cirrhosis. Clinical features, outcomes and predictors of in-hospital mortality. A prospective study

Annals of Hepatology ◽

10.1016/s1665-2681(19)31540-6 ◽

2011 ◽

Vol 10 (3) ◽

pp. 287-295 ◽

Cited By ~ 29

Author(s):

José Alberto González-González ◽

Diego García-Compean ◽

Genaro Vázquez-Elizondo ◽

Aldo Garza-Galindo ◽

Joel Omar Jáquez-Quintana ◽

...

Keyword(s):

Liver Cirrhosis ◽

Gastrointestinal Bleeding ◽

Hospital Mortality ◽

Prospective Study ◽

Clinical Features ◽

Upper Gastrointestinal Bleeding ◽

A Prospective Study ◽

Upper Gastrointestinal

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Histoacryl glue injection without lipiodol dilution and post sclerotherapy bleeding; prevalence among patients with upper GIT bleed.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.06.3982 ◽

2020 ◽

Vol 27 (06) ◽

pp. 1182-1186

Author(s):

Muhammad Ayub ◽

Sagheer Hussain ◽

Salman Ahmed

Keyword(s):

Liver Cirrhosis ◽

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Gastric Varices ◽

Recurrent Bleeding ◽

Endoscopic Sclerotherapy ◽

Ulcer Disease ◽

Acute Upper Gastrointestinal Bleeding ◽

Glue Injection ◽

Upper Gastrointestinal

Objectives: To determine role of histoacryl injection in preventing upper acute upper gastrointestinal bleeding. Study Design: Prospective Study. Setting: Gastroenterology ward of DHQ Teaching Hospital Gujranwala. Period: One year from 1st September 2017 to 31st August 2018. Material & Methods: Patients presented to the study hospital having upper gastrointestinal bleeding of acute onset due to gastric varices bleeding were included in this study. All other cases having upper GIT bleeding due to other causes like peptic ulcer disease, Mallory weise syndrome, gastritis or esophageal varices were not included in this study. Both male and female patients were included irrespective of their age. Hemostasis in these cases was achieved by endoscopic sclerotherapy using histoacryl glue (N-butyl-2-cyanoacrylate) injection without lipoidal dilution. After first session of injection patients were called on follow up after 5 days and they were assessed for recurrent GIT bleeding and treatment failure. All data was documented on a predesigned performa. Frequencies and percentage were calculated and results were expressed in tabular form and graphs. Results: Total 80 cases were studied including 56% male and 44% female cases. Endoscopic sclerotherapy using histoacryl injection proved successful in 87.5% cases and recurrent bleeding occurred in 12.5% cases. Minimum age of patients was 25 years and maximum age 70 years with mean age of 45 years. Total 450 cases presented in study institution with Upper GIT bleeding during study period and causes among them were liver cirrhosis in 92% cases, peptic ulcer disease in 4% cases, Malloryweise Syndrome in 2.5% and gastritis in 1.5% cases. In our study group cause of gastric varices was liver cirrhosis due to viral hepatitis in 73% cases and alcoholic hepatitis in 27% cases. After single session of endoscopic histoacryl glue injection to 80 cases, no bleeding occurred after 5 days in 71(88.7%) cases, recurrent bleeding occurred within 5 days in 9(11.2%) cases. Two cases died due to massive recurrent bleeding and mortality rate was 2.5%. Conclusion: Endoscopic sclerotherapy using Histoacryl injection is very successful treatment for acute upper gastrointestinal bleeding with very low recurrence rate of bleeding and low mortality rate.

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Predictors of in-hospital mortality in a cohort of elderly Egyptian patients with acute upper gastrointestinal bleeding

Medicine ◽

10.1097/md.0000000000010403 ◽

2018 ◽

Vol 97 (16) ◽

pp. e0403 ◽

Cited By ~ 7

Author(s):

Mohamed A. Elsebaey ◽

Heba Elashry ◽

Tamer A. Elbedewy ◽

Ahmed A. Elhadidy ◽

Noha E. Esheba ◽

...

Keyword(s):

Gastrointestinal Bleeding ◽

Hospital Mortality ◽

Upper Gastrointestinal Bleeding ◽

Acute Upper Gastrointestinal Bleeding ◽

Egyptian Patients ◽

Upper Gastrointestinal

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Acute upper gastrointestinal bleeding in liver cirrhosis patients

Biomedical Papers ◽

10.5507/bp.2012.029 ◽

2012 ◽

Vol 156 (3) ◽

pp. 266-270 ◽

Cited By ~ 3

Author(s):

Pavel Svoboda ◽

Michal Konecny ◽

Arnost Martinek ◽

Vladimir Hrabovsky ◽

Vlastimil Prochazka ◽

...

Keyword(s):

Liver Cirrhosis ◽

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Acute Upper Gastrointestinal Bleeding ◽

Upper Gastrointestinal

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ASSESSMENT OF PROGNOSTIC PERFORMANCE OF ALBI, CHILD-PUGH AND MELD SCORES IN PATIENTS WITH LIVER CIRRHOSIS COMPLICATED WITH ACUTE UPPER GASTROINTESTINAL BLEEDING

10.26226/morressier.59a6b346d462b80290b549c0 ◽

2017 ◽

Author(s):

Sofia Xavier

Keyword(s):

Liver Cirrhosis ◽

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Prognostic Performance ◽

Acute Upper Gastrointestinal Bleeding ◽

Upper Gastrointestinal

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No Benefit of Hemostatic Drugs on Acute Upper Gastrointestinal Bleeding in Cirrhosis

BioMed Research International ◽

10.1155/2020/4097170 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Yang An ◽

Zhaohui Bai ◽

Xiangbo Xu ◽

Xiaozhong Guo ◽

Fernando Gomes Romeiro ◽

...

Keyword(s):

Gastrointestinal Bleeding ◽

Hospital Mortality ◽

Upper Gastrointestinal Bleeding ◽

Meld Score ◽

Drug Group ◽

Red Blood Cell Transfusion ◽

Acute Upper Gastrointestinal Bleeding ◽

Rebleeding Rate ◽

Cirrhotic Patients ◽

Upper Gastrointestinal

Background and Aims. Acute upper gastrointestinal bleeding (AUGIB) is one of the most life-threatening emergency conditions. Hemostatic drugs are often prescribed to control AUGIB in clinical practice but have not been recommended by major guidelines and consensus. The aim of this study was to investigate the therapeutic effect of hemostatic drugs on AUGIB in cirrhosis. Methods. All cirrhotic patients with AUGIB who were admitted to our hospital from January 2010 to June 2014 were retrospectively included. Patients were divided into hemostatic drugs and no hemostatic drug groups. A 1 : 1 propensity score matching (PSM) analysis was performed by adjusting age, gender, etiology of liver disease, Child-Pugh score, MELD score, hematemesis, red blood cell transfusion, vasoactive drugs, antibiotics, proton pump inhibitors, and endoscopic variceal therapy. Primary outcomes included 5-day rebleeding and in-hospital mortality. Results. Overall, 982 cirrhotic patients with AUGIB were included (870 in hemostatic drugs group and 112 in no hemostatic drug group). In overall analyses, hemostatic drugs group had a significantly higher 5-day rebleeding rate (18.10% versus 5.40%, P=0.001) than no hemostatic drug group; in-hospital mortality was not significantly different between them (7.10% versus 4.50%, P=0.293). In PSM analyses, 172 patients were included (86 patients in each group). Hemostatic drugs group still had a significantly higher 5-day rebleeding rate (15.10% versus 5.80%, P=0.046); in-hospital mortality remained not significantly different (7.00% versus 3.50%, P=0.304) between them. Statistical results remained in PSM analyses according to the type of hemostatic drugs. Conclusions. The use of hemostatic drugs did not improve the in-hospital outcomes of cirrhotic patients with AUGIB.

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