Variceal bleeding is a frequent complication of cirrhosis and is associated with a high risk of early rebleeding.
In patients with peptic ulcers, continued bleeding or early rebleeding are risk factors for mortality and can be predicted by statistical models ; however, no such models exist for acute variceal bleeding.
We prospectively evaluated failure to control bleeding in 695 consecutive patients with cirrhosis, admitted for haematemesis and/or melaena.
Criteria were defined for failure to control bleeding, which comprised both continued bleeding or early rebleeding within 5 days of admission.
(i) those with variceal bleeding initially treated with blood transfusion and vasoactive drugs, and if these failed followed by sclerotherapy (n=385) ; (ii) those with variceal bleeding treated with injection sclerotherapy at diagnostic endoscopy (n=144).
The third group was those with bleeding from other sources related to portal hypertension (n=166).
Failure to control bleeding was noted in 169 (44%) patients in group 1,55 (38%) in group 2 and 44 (25%) in group 3. Twenty variables that were evaluable within 6 h of admission, pertaining to severity of bleeding, severity of type of liver disease, mode of admission, and time of diagnostic endoscopy, were entered into a multivariate Cox model. (...)
Mots-clés Pascal : Cirrhose, Complication, Précoce, Hémorragie, Varice, Protocole expérimental, Facteur prédictif, Récurrence, Taux risque, Mortalité, Evaluation, Echec, Etude comparative, Homme, Appareil digestif pathologie, Foie pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Statistique
Mots-clés Pascal anglais : Cirrhosis, Complication, Early, Hemorrhage, Varix, Experimental protocol, Predictive factor, Recurrence, Risk rate, Mortality, Evaluation, Failure, Comparative study, Human, Digestive diseases, Hepatic disease, Cardiovascular disease, Vascular disease, Statistics
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0465438
Code Inist : 002B13C03. Création : 22/03/2000.