PROGNOSTIC FACTORS OF EARLY MORTALITY IN CIRRHOTIC-PATIENTS AFTER THEFIRST EPISODE OF VARICEAL BLEEDING

Aim: To assess the prognostic factors of early mortality in cirrhotic patients with the first variceal bleeding episode. Patients and method s: Fifty-five cirrhotic patients with endoscopic evidence of variceal bleeding treated with sclerotherapy during emergent endoscopy were inc luded, Results: Permanent hemostasis was obtained in 36 patients (65.5 %). Fourteen (25.4%) patients died within six weeks of the bleeding ep isode, Twenty-four variables obtained at admission and in the followin g days were compared between patients who survived (n= 41), and died ( n= 14), In the univariate analysis the following variables were relate d to early mortality: prothrombin ratio (p= 0.04), the presence of asc ites (p= 0.004) and encefalopathy (p= 0.06), albumin (p= 0.01), Child- Pugh score (p= 0.0003), hemostasis during endoscopy (p= 0.002), absenc e of rebleeding at 24 hours (p= 0.01) and early rebleeding (within fiv e days after the bleeding episode) (p= 0.006). Multiple logistic regre ssion identified the Child-Pugh score (OR 11.86, CI95% 2.54-55.48; p= 0.001) and early rebleeding (OR 6.27, CI95% 1.29-30.44; p= 0.02) as pr ognostic independent factors of early mortality, Conclusions: The degr ee of hepatic failure and early rebleeding are prognostic independent factors of early mortality in cirrhotic patients after the first varic eal bleeding episode.