Factors Predicting Early Rebleeding After Endoscopic Variceal Ligation

BackgroundCurrently,there is no well-established model for accurate prediction of survival in patients with cirrhosis following an episode of AVH.Rebleeding is common following variceal hemorrhage.Hypercoagulable events occur in cirrhosis patients with gastrointestinal bleeding(GIB) despite the well-known bleeding diathesis of liver disease.AimsTo analyze the independent risk factors and survival of early bleeding after endoscopic variceal ligation(EVL).Methods259 cirrhotic patients with esophageal varices who underwent EVL for treatment of esophageal varices were analyzed.The variables for risk factors analysis included the sex,age,hepatic coma,red color sign,complication,blood loss,diet,exercise load, portal vein width,gastric varices,blood loss,transfusion volume,with or without portal vein thrombosis,etiology of cirrhosis,location and number of varices,history of devascularization or splenectomy,the Crade classification,Child-Pugh status,,ascites,basic laboratory data,with or without administration of proton pump inhibitor(PPI),somatostatin,hy-pophysin,thrombin,mucosal protective agents.,β-blockers. ResultsPortal vein thrombosis,prolonged prothrombin time,ascites,Child-Pugh status and hemoglobin were independently associated with the early rebleeding after EVL. Rebleeding within 7 days occurred in 22 patients(8.49%) with 7 deaths(31.8%).ConclusionsPatientes with portal vein thrombosis,prolonged prothrombin time,hard diet,ascites and low hemoglobin are at increased risk of dying within 7 days after EVL.We should closely monitor the symptoms of coagulation abnormalities in cirrhotic patients, especially in cirrhotic patients with poor liver reserve.