Chirurgia (Bucharest, Romania : 1990) · 2004
[Risk factors for the immediate outcome of gastrointestinal bleeding in patients with cirrhosis].
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Păunescu V, Grigorean V, Popescu C
Аннотация
The risk factors in the immediate outcome of gastrointestinal bleeding were examined in a prospective study of 134 patients with liver cirrhosis. The hemorrhagic episode has a negative prognosis in the immediate outcome (p < 0.01), recording 48 (35.82%) deaths. The deaths occurred in the acute phase of bleeding (n = 18; 13.40%), after recurrent hemorrhage (n = 24; 17.23%) and in 6 other cases (4.47%) after sclerotherapy or surgical treatment of varicosities. After varicose veins sclerotherapy (n = 8), 2 deaths were recorded and 4 other after surgery (n = 22). The advanced stage of cirrhosis, Child C stage, (n = 62) was accompanied by most of deaths (n = 38; 61.29%) (p < 0.01). Among the risk factors responsible for death, there were recorded: encephalopathy (p < 0.05), jaundice (p < 0.01), altered general status ((p < 0.01) and increased seric level of bilirubin over 3 mg% (p < 0.001). Jaundice is among the risk factors with the highest sensitivity (83.33%) and seric bilirubin over 3 mg% has the highest positive predictive value (64.28%).