Post Banding Ulcer Haemorrhage: a Contributor to Morality in Patients with Liver Cirrhosis
DOI:
https://doi.org/10.51253/pafmj.v73i6.8835Keywords:
Endoscopy, Endoscopic variceal band ligation (EVBL), Model for end-stage liver disease score, Post banding ulcer haemorrhageAbstract
Objectives: To evaluate the frequency, risk factors and mortality of post-banding bleeding in cirrhosis.
Study Design: Retrospective longitudinal Study.
Place and Duration of Study: Department of Medicine, Fauji Foundation Hospital, Rawalpindi Pakistan, from Feb to Jul 2021.
Methodology: Esophageal variceal band ligation (EVBL) was done in 123 patients. The study cohort was divided into two
groups: Group-1 without re-bleed and Group-2 with re-bleed. Blood chemistry, Child-Pugh and MELD score, including the
indications of EVBL and risk factors, were also analysed. Regression analysis was performed.
Results: Re-bleed occurred in 10.6% (n=13) of patients. The mean duration between ligation and re-bleed was 8.75±2.8 days. Oesophageal ulcers were the most common cause of re-bleeding (38.5%). Mortality rates among the two groups were 21.8 %( n=24) and 30.8 %( n=4), respectively. The model for end-stage liver disease score (OR 2.177, CI 1.069-4.43, p .03), APTT (OR 0.593, CI 0.397-0.887, p .01) and Sodium (OR 1.345, CI 1.07-1.69, p<0.01) were detected as the predictors of re-bleed.
Conclusion: Although re-bleeding after banding occurs in a trivial number of patients, it contributes to mortality.
Coagulopathy, high sodium and MELD score are major predictors.
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