6-Week mortality predictors in patients with acute variceal bleeding from the western national medical center of the Mexican social security institute
Introduction and Objectives: To identify the predictive factors for mortality at six weeks in patients with variceal bleeding. Materials and methods: A retrospective cohort study in the Department of Gastroenterology of the National Medical Center of the West, from January-December 2021. Results: Se...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Annals of Hepatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268122001363 |
| _version_ | 1811213415395360768 |
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| author | UI Martín-Flores JF Aguayo-Villaseñor ME Contreras-Marín |
| author_facet | UI Martín-Flores JF Aguayo-Villaseñor ME Contreras-Marín |
| author_sort | UI Martín-Flores |
| collection | DOAJ |
| description | Introduction and Objectives: To identify the predictive factors for mortality at six weeks in patients with variceal bleeding. Materials and methods: A retrospective cohort study in the Department of Gastroenterology of the National Medical Center of the West, from January-December 2021. Results: Seventy patients with variceal bleeding were included (table 1). The 6-week mortality was 25.7% and the early rebleeding rate was 22.9%. The main predictors of mortality were a Child-Pugh class C score OR 7.67(95% CI, 2.25-26.15, p=0.0011), a MELD score ≥20 OR 20.0(95% CI, 5.58-94.74, p=<0.0001), ABC score ≥8 OR 32.0(95% CI, 3.91-261.54, p=0.0012) and Blatchford score ≥15 OR 9.60(95% CI, 2.51-38.16, p=0.0013); Similarly, the presence of other decompensations such as acute kidney injury (OR 4.77, p=0.0088), hepatic encephalopathy (OR 18.85, p=<0.0001), ACLF (OR 65.0, p=<0.0001), and a no-SBP infection (OR 3.83, p=<0.0001) were identified as predictors Discussion: The mortality at six weeks and early rebleeding, as well as mortality predictors, match what is reported in the international literature. Conclusions: Poor hepatic function reserve, which is related to higher comparisons of Child-Pugh and MELD scores, are independent predictors of mortality in variceal bleeding due to the high portal venous pressure gradients managed by these patients. Similarly, the presence of other decompensations, such as acute kidney injury, hepatic encephalopathy, and ACLF, also increase the risk of death when they occur in conjunction with variceal bleeding. Funding: The resources used in this study were from the hospital without any additional financing Declaration of interest: The authors declare no potential conflicts of interest. |
| first_indexed | 2024-04-12T05:46:22Z |
| format | Article |
| id | doaj.art-6a32fb7113b44770a9cf253f273912f9 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-04-12T05:46:22Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-6a32fb7113b44770a9cf253f273912f92022-12-22T03:45:27ZengElsevierAnnals of Hepatology1665-26812022-12-01271007946-Week mortality predictors in patients with acute variceal bleeding from the western national medical center of the Mexican social security instituteUI Martín-Flores0JF Aguayo-Villaseñor1ME Contreras-Marín2Department of Gastroenterology and Endoscopy. Specialty Hospital. Western National Medical Center. Mexican Social Security Institute. MexicoDepartment of Gastroenterology and Endoscopy. Specialty Hospital. Western National Medical Center. Mexican Social Security Institute. MexicoDepartment of Gastroenterology and Endoscopy. Specialty Hospital. Western National Medical Center. Mexican Social Security Institute. MexicoIntroduction and Objectives: To identify the predictive factors for mortality at six weeks in patients with variceal bleeding. Materials and methods: A retrospective cohort study in the Department of Gastroenterology of the National Medical Center of the West, from January-December 2021. Results: Seventy patients with variceal bleeding were included (table 1). The 6-week mortality was 25.7% and the early rebleeding rate was 22.9%. The main predictors of mortality were a Child-Pugh class C score OR 7.67(95% CI, 2.25-26.15, p=0.0011), a MELD score ≥20 OR 20.0(95% CI, 5.58-94.74, p=<0.0001), ABC score ≥8 OR 32.0(95% CI, 3.91-261.54, p=0.0012) and Blatchford score ≥15 OR 9.60(95% CI, 2.51-38.16, p=0.0013); Similarly, the presence of other decompensations such as acute kidney injury (OR 4.77, p=0.0088), hepatic encephalopathy (OR 18.85, p=<0.0001), ACLF (OR 65.0, p=<0.0001), and a no-SBP infection (OR 3.83, p=<0.0001) were identified as predictors Discussion: The mortality at six weeks and early rebleeding, as well as mortality predictors, match what is reported in the international literature. Conclusions: Poor hepatic function reserve, which is related to higher comparisons of Child-Pugh and MELD scores, are independent predictors of mortality in variceal bleeding due to the high portal venous pressure gradients managed by these patients. Similarly, the presence of other decompensations, such as acute kidney injury, hepatic encephalopathy, and ACLF, also increase the risk of death when they occur in conjunction with variceal bleeding. Funding: The resources used in this study were from the hospital without any additional financing Declaration of interest: The authors declare no potential conflicts of interest.http://www.sciencedirect.com/science/article/pii/S1665268122001363 |
| spellingShingle | UI Martín-Flores JF Aguayo-Villaseñor ME Contreras-Marín 6-Week mortality predictors in patients with acute variceal bleeding from the western national medical center of the Mexican social security institute Annals of Hepatology |
| title | 6-Week mortality predictors in patients with acute variceal bleeding from the western national medical center of the Mexican social security institute |
| title_full | 6-Week mortality predictors in patients with acute variceal bleeding from the western national medical center of the Mexican social security institute |
| title_fullStr | 6-Week mortality predictors in patients with acute variceal bleeding from the western national medical center of the Mexican social security institute |
| title_full_unstemmed | 6-Week mortality predictors in patients with acute variceal bleeding from the western national medical center of the Mexican social security institute |
| title_short | 6-Week mortality predictors in patients with acute variceal bleeding from the western national medical center of the Mexican social security institute |
| title_sort | 6 week mortality predictors in patients with acute variceal bleeding from the western national medical center of the mexican social security institute |
| url | http://www.sciencedirect.com/science/article/pii/S1665268122001363 |
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