MORTALITY ASSOCIATED WITH VARICEAL BLEED IN CIRRHOSIS PATIENTS ATTENDING A TERTIARY CARE CENTRE IN SOUTH KERALA.

Abstract

Background : Acute variceal bleeding is a most common complication of portal hypertension. Despite advancement in management of variceal bleeding still carries a very high morbidity and mortality. The present study was undertaken to study mortality associated with variceal bleed in cirrhotic patients attending a tertiary care hospital. Method : This prospective study was conducted between June 2016 to may 2018. Total 60 patients included in the study who admitted with acute variceal bleeding episode with underlying cirrhosis. Results : Majority of patients were male ( 76 %). The mean age of patients was 54 +/- 13.7. Most common etiology of cirrhosis was Alcohol related liver disease (51.7% ). Most common presenting symptom was hematemesis with melena(41.7%). Majority of patients presented with recurrent bleeding episodes (61.7% ). 18.3% Patients had rebleeding episode within 5 days of admission. Total 21 (35 % ) patients died during study period. Univariate analysis showed advance age, presence of ascites, Encephalopathy, high creatinine, bilirubin and INR were important predictors of mortality. In multivariate analysis only signicant predictors was serum creatinine (OR 43.1 (CL3.05 to 608.64)). Conclusion: Patients with cirrhosis are always at risk of variceal bleeding. The survival after a bleeding episode was inuenced by age, comorbidities, in hospital complications, ascites, high CTPand MELD score , beta blocker therapy