Analysis Of Prognostic Factors Of Liver Cirrhosis Copmlicated By Esophageal-gastric Variceal Bleeding

Objective:The aim of this study was to investigate the prognostic factors of liver cirrhosis complicated by esophageal-gastric variceal bleeding(EGVB) and provide basis for the treatment and prognosis judgement of liver cirrhosis complicated by EGVB.Method:100 patients with liver cirrhosis complicated by EGVB were come from The First Affiliated Hospital of Jinan University,The Forth Affiliated Hospital of Jinan University and The Sixth Affiliated Hospital of Sun Yat-sen University between Jan 1999 and Sep 2007 in the study.Medical records of these patients were retrospectively reviewed.The follow-up period was from the date of being diagnosed with liver cirrhosis complicated by EGVB to the date of death or discharging from hospital.33 variables were selected from clinical and physiochemical examinations at the episode of liver cirrhosis complicated by EGVB.The prognostic factors of liver cirrhosis complicated by EGVB were selected from these 33 variables by Cox regression analysis and a prognostic index(PI) model for liver cirrhosis complicated by EGVB was established.Result:For these 100 patients with liver cirrhosis complicated by EGVB,the average time in hospital was 23.66 days,the median time was 17.50 days.18 patients died during the follow-up period,which the cumulative death rate was 18%.Two factors,that is,shock and the Child-pugh score,were selected eventually as indepentdent factors that significantly correlated with the outcome of liver cirrhosis complicated by EGVB.The PI value was calculated by the formula of PI=-4.756+0.480×Child-Pugh score+1.154×shock value.The 100 patients were divided into low-PI,median-PI and high-PI groups according to their PI valuse which were ascending sorted.It indicated that the cumulative survival rate of the low-PI group was the higst and the high-PI group was the lowest in the three groups(low-PI group＞median-PI group＞ high-PI group) by Log-rank test(P＜0.05).Conclusion:the Child-pugh score and shock are inedpendent prognostic factors of cirrhosis complicated by EGVB.The formula of PI value is PI=-4.756+0.48×Child-Pugh score+1.154×shock value.The higher the PI value means the poorer prognosis in cirrhosis complicated by EGVB,On the contrary,The lower the PI value means the better prognosis.PI value provides an index for the determination of the therapeutic approach and prognosis judgment of cirrhosis complicated by EGVB.