The Correlated Risk Factors For The First Rupture Bleeding Of Gastric Varices In Patients With Sinistral Portal Hypertension:a Retrospective Cohort Study

Objective: To analyze risk factors leading to gastric variceal bleeding in patients with sinistral portal hypertension and to provide the early assement for clinicians.Materials and methods: From February 1,2009 to March 1,2019,78 patients with sinstral portal hypertension were enrolled in the First Affiliated Hospital of Nanchang University.According to their history of the variceal bleeding before admission,patients were divided into the bleeding group(30 cases)and control group(48 cases).The general information variables(age,gender,etiology,disease course),laboratory variables(platelets,activate part clotting prothrombin time,prothrombin time),abdominal CT variables(thickness of spleen,short gastric vein diameter,gastroepiploic vein diameter)and endoscopy variables(varicose veins,the maximal gastric varicose diameter,RC sign).Statistically significant variables were used for further non-conditional logistic regression analysis to identify the independent risk factors of gastric variceal bleeding in patients with SPH.Receiver operating characteristic curve(ROC)were performed and area under the curve(AUC)was calculated.The nomogram were drawed by using R software.Results: Univarite analysis showed 6 variables were statistically significant(P < 0.05),PLT(platelet count),PT(prothrombin time),SGV(short gastric vein diameter),GEV(gastroepiploic vein diameter),varicose vein diameter and RC sign,respectively.Non-conditional Logistic regression showed the PLT count(P=0.016,OR:0.982,95% CI:0.968-0.997),SGV diameter(P=0.006,OR:7.151,95% CI:1.761-29.044),the maximal diameter of varicose vein(P=0.025,OR:4.909,95% CI:1.216-19.816)and RC sign(P=0.04,OR:3.889,95% CI:1.063-14.237)were independent risk factors for gastric varices bleeding in patients with SPH.AUC of the prediction model was 86.5%.Conclusion: The independent risk factors for gastric varices bleeding in patients with SPH were PLT,SGV,the maximal diameter of varicose vein,and RC sign.The indexes positively correlated with GVB were SGV,the maximal diameter of varicose vein and RC sign while the indexes negatively correlated with GVB were PLT.This prediction model showed considerable predicable value for gastric varices bleeding in patients with SPH,but it still needs to be evaluated by further and more studies.