Centenary of the UCT Faculty of Health Sciences
Outcome in decompensated alcoholic cirrhotic patients with acute variceal bleeding
Abstract
Methods. From January 1984 to August 2011, 448 alcoholic cirrhotic patients (349 men, 99 women; median age 50 years) with VB underwent endoscopic treatments (556 emergency, 249 elective) during the index hospital admission. Endoscopic control of initial bleeding, variceal rebleeding and survival after the first hospital admission were recorded.
Results. Endoscopic intervention alone controlled VB in 394 patients (87.9%); 54 also required balloon tamponade. Within 24 hours 15 patients rebled; after 24 hours 61 (17%, n=76) rebled; and 93 (20.8%) died in hospital. No Child-Pugh (C-P) grade A patients died, while 16 grade B and 77 grade C patients died. Mortality increased exponentially as the C-P score increased, reaching 80% when the C-P score exceeded 13.
Conclusion. Despite initial control of variceal haemorrhage, 1 in 6 patients (17%) rebled during the first hospital admission. Survival (79.2%) was influenced by the severity of liver failure, with most deaths occurring in C-P grade C patients.
Authors' affiliations
Jake E J Krige, Department of Surgery, Faculty of Health Sciences, University of Cape Town and Surgical Gastroenterology Unit, Groote Schuur Hospital, Cape Town
Urda K Kotze, Department of Surgery, Faculty of Health Sciences, University of Cape Town and Surgical Gastroenterology Unit, Groote Schuur Hospital, Cape Town
Rauf Sayed, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town
Sean Burmeister, Department of Surgery, Faculty of Health Sciences, University of Cape Town and Surgical Gastroenterology Unit, Groote Schuur Hospital, Cape Town
Marc Bernon, Department of Surgery, Faculty of Health Sciences, University of Cape Town and Surgical Gastroenterology Unit, Groote Schuur Hospital, Cape Town
Galya Chinnery, Department of Surgery, Faculty of Health Sciences, University of Cape Town and Surgical Gastroenterology Unit, Groote Schuur Hospital, Cape Town
Keywords
Cite this article
Article History
Date published: 2012-05-23
Article Views
Full text views: 4104
Comments on this article
*Read our policy for posting comments here