Upper gastrointestinal bleeding in patients with liver cirrhosis, Is the difference of clinical outcomes depend on the source?

Abstract

Background and Study Aims Acute upper gastrointestinal bleeding (UGIB) is the most common gastroenterological emergency in patients with cirrhosis; It increases the hospital length of stay (LOS), and Chance of 30-day hospital readmission. It has not been clarified if there is a difference in the prognosis of UGIB in cirrhosis depending on the source of bleeding. We aimed to investigate clinical outcomes in patients with cirrhosis with either acute variceal bleeding (AVB) or non-variceal bleeding (NVB) and risk factors for prolonged hospital LOS in both groups.Patients and Methods From July 2016 to January 2017, all adult eligible patients hospitalized with cirrhosis and UGIB were enrolled in the retrospective study, we assessed clinical outcomes in both groups and factors associated with prolonged hospital LOS.Results Of the 608 patients included in the study, 416 had variceal and 192 non-variceal bleeding. Mortality was higher in AVB group compared to NVB (12.5% vs. 8.3%, P= 0.023). There was a trend towards increased the length of hospital stay for those who had an AVB compared to NVB (5.84±2.16 vs. 4.33±1.18, p=0.001). Rate of hospital Readmission was also higher in the AVB group. Risk factors for prolonged hospital LOS were in hospital rebleeding, presence of Hepatic encephalopathy or ascites, higher MELD score and Patients with child score B, C.Conclusion Patients with cirrhosis and AVB have higher mortality rate, longer hospital LOS and re-hospitalization rate than those with NVB.