Objective To explore the influencing factors of survival in patients with gastroesophageal varices with drug treatment after repeated gastrointestinal bleeding.Methods A retrospective study was conducted on 81 patients with esophageal and gastric variceal hemorrhage from cirrhosis admitted to our hospital from January 2016 to December 2022 who refused endoscopic therapy and only received drug therapy.The baseline information of all the patients were collected,including age,sex,etiology of cirrhosis,liver function grading(Child-Pugh grading),ascites,hepatic encephalopathy,liver cancer,esophageal and gastric varices classification(LDRf classification),and bleeding times.Receiver operating characteristic curve(ROC)was used to define the optimal cut-off values of age and bleeding times for predicting death.Univariate and multivariate COX regression models were used to analyze the factors affecting the survival of patients with gastroesophageal varices treated with drugs after repeated gastrointestinal bleeding.Results ROC analysis showed that the best cut-off value of age and gastrointestinal bleeding times to predict death was 76 years old,4 times.Multivariate COX regression model analysis results showed that complicated liver cancer[HR=3.609,95% confidence interval(95% CI)1.688～7.718,P=0.001],bleeding≥4 times(HR=2.626,95% CI:1.095～6.299,P=0.031)were independent risk factors for death in patients with EVB,and previous endoscopic therapy(HR=0.171,95% CI:0.068～0.435,P<0.001)was an independent protective factor in patients with EVB.Conclusion EVB patients complicated with liver cancer and bleeding times≥4 have a higher mortality rate.Therefore,more active treatment should be given during hospitalization,and endoscopic therapy is recommended to reduce the risk of death.
万方数据
维普
