Risk Factors Of Esophageal Varices Bleeding In Patients With Liver Cirrhosis

Objective:To investigate risk factors of esophageal varices bleeding (EVB) in patients with liver cirrhosis.Methods:This is a retrospectie investigationl.119 hospitalized patients with cirrhosis who occurred EVB in the Second Affiliated Hospital of Dalian Medical University during February 1993 to September 2007 were selected as EVB group.104 sex-and-age matched hospitalized cirrhotic patients with cirrhosis company with esophageal varices but no hemorrhage who survived in the corresponding time period were selected as control group. Patients who had ever sufferde from gastrointestinal bleeding, liver carcinoma, undergoing past experiences of sclerosis or band ligation of oesophageal varices, trans-jugular intrahepatic portosystemic shunt (TIPS),or surgery for portal hypertension were excluded from this study. 22 factors such as age, gender, cause of course, drinking history, platelet count (PLT), prothrombin time (PT), prothrombin activity (PTA), activated partial thromboplastin time (APTT), serum total bilirubin (TB), serum albumin (ALB), serum Na+ concentration, serum K+ concentration, diameter of the spleen and portal vein, thickness of the spleen, ascites, degree of esophageal varices, red color sign, varices, hepatic encephalopathy, Hepatorenal syndrome and Child-Pugh classification were analysed. First, all the variables were examined by univariate analysis.Then those with statistical significance in univariate analysis were examined with a multivariate analysis using Logistic regression procedures, to verify the major risk factors of EVB with cirrhosis.Results:Univariate analysis showed that PLT, PT, PTA, diameter of the portal vein, diameter of splenic vein, degree of esophageal varices and red color sign demonstrated statistical significance (p<0.05) between EVB group and non-EVB group in liver cirrhosis. Multivariate Logistic regression analysis showed that red color sign, diameter of the portal vein, degree of esophageal varices correlated positively with EVB in liver cirrhosis,while blood platelets count did negtively.The regression coefficients were1.645,2.552,0.69 and -0.007 respectively. Relative risks were14.089, 12.831, 1.993 and 0.993 respectively.Conclusion:1.Red color sign, increased diameter of the portal vein and degree of esophageal varices were independent risk factors of esophageal varices bleeding in patients with liver cirrhosis, and red color sign was the most important risk factor.2.Decreased blood platelets count was an independent risk factor of esophageal varices bleeding in patients with liver cirrhosis.