Ascites and serum bilirubin value predict survival in acute variceal bleeding

S Afr Med J. 1990 Apr 7;77(7):334-8.

Abstract

Factors affecting the outcome of acute variceal haemorrhage treated by injection sclerotherapy were analysed. The data on 82 patients undergoing their first admission for acute variceal bleeding were collected prospectively. Using multiple logistic regression analysis and multiway contingency table analysis only the presence of ascites and an elevated serum bilirubin value contributed independently to survival out of a total of 26 discontinuous and 12 continuous variables. A derived regression equation was constructed to predict survival using the data from the 82 patients and this was tested against the observed outcome in a different group of 113 patients also undergoing their first variceal haemorrhage treated by injection sclerotherapy, the data from whom were also collected prospectively. Using a cut-off point of P = 0,71, the equation accurately predicted death for 91% of patients who died and accurately predicted survival for 65% of patients who survived. Overall accuracy of prediction was 73%.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Analysis of Variance
  • Bilirubin / blood*
  • Esophageal and Gastric Varices / blood
  • Esophageal and Gastric Varices / mortality*
  • Esophageal and Gastric Varices / therapy
  • Female
  • Gastrointestinal Hemorrhage / blood
  • Gastrointestinal Hemorrhage / mortality*
  • Gastrointestinal Hemorrhage / therapy
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Sclerotherapy

Substances

  • Bilirubin