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In Iraqi Cirrhotic Patients, Can Oesophageal Variceal Bleeding Make Child Pugh Score more Predictive of outcome and Mortality

Author: Ali A. Alshareefy
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2013 Volume: 10 Issue: 3 Pages: 590-599
Publisher: Babylon University جامعة بابل

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Abstract

Background: Variceal bleeding is a leading cause of mortality and morbidity in patients with liver failure (i.e. acute and chronic) cases. Aim of Study: To evaluate the prognostic value of Variceal bleeding in addition to Child Pugh Score (CPS). Materials and Methods: A hospital based cross sectional study was carried out on patients with chronic liver failure attending Babylon Gastrointestinal and Hepatology Centre. Results: A total of 1786 patients with liver diseases were seen at the tertiary hospital, 127 (7.11%) were with chronic liver failure. The overall mean age of those patients with chronic liver failure with bleeding presentation was 47.62 ± 17.14 years and of those patients without bleeding presentation was 49.50 ± 15.10 years. Majority (65.4%) of patients were male and (92.1%) of patients were married. Majority (45.7%) of patients with chronic liver failure were from Al-Hillah city. Majority (55.1%) of patients with chronic liver failure were presenting with abnormal liver tests followed by ascites (24.4%) and bleeding (20.5%). Majority (58.3%) of the patients with chronic liver failure their primary aetiology were viral infection. Meanwhile, HBV was constituted (31.5%) of all primary aetiology followed by HCV (26.8%). Majority (59.0%) of patients with chronic liver failure were class A, meanwhile only (33.9%) and (7.1%) were class B and C, respectively. there were significant associations between haemorrhagic presenting feature with CPC and primary aetiology. Conclusion: The findings support the importance and significance of the prognostic and predictive value of variceal bleeding in the assessment of patients with chronic liver diseases for further treatment, liver transplantation or the overall mortality. The additive value of variceal bleeding to CPS is still to be defined and formalized and further work is needed to address this important issue.

يعد نزف دوالي المرئ من الأسباب الرئيسية المؤدية الى الوفاة والأضرار الطبية الأخرى عند المرضى المصابين بتشمع الكبد0 الغرض من البحث هو تقييم النظم المستخدمة لتقييم درجة تطور المرضى والمخاطر المحتملة له مع التركيز على اعتبار نزف دوالي المرئ مؤشرا مهما يمكن إضافته إلى نظام (Child Pugh) لزيادة قوته التقيمية0 الطريقة: تمت دراسة مجموعه المرضى المصابين بتشمع الكبد وعددهم (127) مريضا من الأعراض والمؤثرات المستخدمة في نظام (Child Pugh) 0 اظهر البحث ان معظم المرضى (58,3) هم من المصابين بالتهاب الكبد الفايروسي المزمن (C+B) وفي المراحل الاولية للمرضى بحسب تصنيف الناتج من تطبيق النظام Child Pugh)) وهم في طبقة (A) اظهر البحث وجود العلاقة المدعمة إحصائيا بين وجود دوالي المرئ النازفة وموقع المرض او المريض في سلم طبقات النظام التقييمي( Child Pugh) الكلمات الرئيسة: تشمع الكبد, دوالي المرئ , نظام( Child Pugh)

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