Frequency, Determinants and Outcome of Upper Gastrointestinal Bleed among Patients with Liver Cirrhosis

Abstract

Upper gastrointestinal bleed (UGIB) is among one of the common clinical manifestations encountered in emergency departments. UGIB can manifest in form of hematemesis, melena and/or hematochezia. This study was undertaken to study frequency and determinants of upper gastrointestinal bleed in patients with liver cirrhosis and to assess the outcome of patients of liver cirrhosis presenting with upper gastrointestinal bleed. This study was conducted among 100 patients with documented cirrhosis of liver admitted to different wards of Rajindra Hospital attached to Govt. Medical College, Patiala, India.. Patients of liver cirrhosis with presenting complaints of upper gastrointestinal bleed were recruited as the study group and the patients of liver cirrhosis without UGIB were assessed as the control group. Upper gastrointestinal endoscopy was done to identify cause of UGIB. Patients with UGIB were followed up at 0, 3 and 6 month interval to assess the outcome. UGIB was detected among 53 (53%) among 100 subjects enrolled in the study. Previous history of upper gastrointestinal Bleed, NSAIDs intake, Binge alcohol drinking, presence of red colour signs, presence of medium and large size varices, evidence of varices in esophagus and stomach, low platelet count, deranged coagulation profile (prothrombin time and INR) and increased portal vein diameter were determinants of upper gastrointestinal bleed. In conclusion, early identification of these determinants combined with logical prescription to those with cirrhosis of liver can aid in deceasing the frequency of upper gastrointestinal bleed.