Gut Liver.  2012 Oct;6(4):476-481.

Changes in the Clinical Outcomes of Variceal Bleeding in Cirrhotic Patients: A 10-Year Experience in Gangwon Province, South Korea

• Kim YD
• Cheon GJ
• Kim MY
• Suk KT
• Baik SK
• Kim DJ

Abstract

BACKGROUND/AIMS
Variceal rupture is one of the main causes of mortality in cirrhotic patients. However, there are limited data on the long-term outcomes of variceal bleeding.
METHODS
We investigated the incidence and mortality of variceal bleeding at three endoscopic centers in Gangwon province during 3 periods (August 1996 to July 1997, August 2001 to July 2002, and August 2006 to July 2007).
RESULTS
A total of 1,704 upper gastrointestinal (GI) bleedings occurred during the study periods. Peptic ulcers were found in 825 patients (48.5%), and variceal ruptures were found in 607 patients (35.6%). The variceal bleeding rate did not decrease in each period (26.0% vs 43.7% vs 33.9%, respectively). In the variceal bleeding group, the 6-week mortality rate steadily and significantly decreased (15.5% vs 10.8% vs 6.4%, respectively, p=0.027). In addition, the mortality rate was significantly higher in the variceal bleeding group than in the non-variceal bleeding group (10.4% vs 2.0%, p<0.001; odds ratio, 5.659; 95% confidence interval, 3.445 to 9.295).
CONCLUSIONS
Variceal bleeding was still the major cause of upper GI bleedings and did not decrease in prevalence over the 10-year period in Gangwon province, South Korea. However, the mortality rate of variceal bleeding decreased significantly.

Keyword

Gastrointestinal hemorrhage; Liver cirrhosis; Esophageal and gastric varices; Mortality

MeSH Terms

Esophageal and Gastric Varices
Gastrointestinal Hemorrhage
Hemorrhage
Humans
Incidence
Liver Cirrhosis
Odds Ratio
Peptic Ulcer
Prevalence
Republic of Korea
Rupture