Esophageal Gastric Varices Early Rebleeding After Endoscopic Treatment Influence Factors Analysis

BackgroundEndoscopic Variceal sclerotherapy and ligation is the main therapy for esophageal and gastric variceal bleeding, it can effectively stop bleeding and successfully block varices.But some patients still developed re-bleeding after the endoscopic therapy. Further study is needed in order to reduce the re-bleeding rate.ObjectiveTo explore the early re-bleeding risk factors after endoscopic therapy of gastroesophageal varices through a retrospective analysis.MethodsTotally300cases with esophagus and/or gastric varices had been performed endoscopic therapy in China-Japan Friendship Hospital from November1985to December2010.The demographic data, clinical manifestations, laboratory tests and endoscopic therapy data, were retrospectively analyzed. All the patients were divided into early re-bleeding group and non-re-bleeding group. SPSS17software was used for all statistical analyses. Bivariate associations between categorical variables were analyzed by Pearson’s chi-square test. Normally distributed continuous variables were stated as mean±SD, and Student’s t-test was used to assess the difference between those variables. Non-normally distributed continuous variables were stated as the median(interquartile range),and Mann-Whitney U non-parametric test was used to assess the difference between those variables. We then selected the significant candidate variables identified by univariate analysis to undergo binary logistic regression analysis (forward stepwise) to determine the independent risk factors for early bleeding. Two-sided P-values<0.05were considered statistically significant.ResultsAmong the300patients with gastroesophageal varices,23patients (7.7%) developed early re-bleeding after endoscopic therapy were assigned to re-bleeding group, while277patients without re-bleeding in the control group. Man (P=0.04), more ascites (P=0.032), larger portal vein (P=0.046), higher serum creatinine (P=0.049), lower serum sodium (P=0.033), were more likely to re-bleeding after endoscopic therapy.The significant candidate variables were selected for forward stepwise logistic regression analysis to find the independent risk, factors for early re-bleeding.Two variables were identified:ascites (OR3.505,95%CI1.169～10.512,P=0.025), higher serum creatinine (OR1.016,95%CI1.002～1.031,P=0.028).ConclusionsEarly re-bleeding after endoscopic therapy of gastroesophageal varices is mainly affected by ascites and higher serum creatinine. More care should be adopted before and after endoscopic procedures for patients with these risk factors.