Background:
Epidemiologic data on incidence, treatment modalities and outcome of patients with
acute variceal bleeding (AVB) at the UK Sankt Pölten is lacking. With this prospective
register, we aim to improve evidence-based patient management.
Methods:
A prospective registry recruiting consecutive patients with AVB at the UK St. Pölten
was implemented since 01/2018. Events of interest are (i) failure to control bleeding
within 5 days, (ii) AVB-related mortality within 6 weeks, and (iii) overall survival.
Patients' characteristics, laboratory parameters, treatment and implementation of
secondary prophylaxis are documented.
Results:
Since January 2018, n = 17 patients (15 male, 88,2%) were included in the register.
We observed a median MELD-score of 14, Child-Pugh (A: 6, B: 8, C: 3). Alcoholic liver
disease was the most common etiology of liver cirrhosis (n = 13, 76,5%) followed by
viral hepatitis (n = 2, 11,8%). Active bleeding at endoscopy was documented in n =
7 patients. Failure to control bleeding occurred in n = 3 patients, of which all patients
died in the first six weeks of follow up. At the time of AVB, only 41,2% of cirrhotic
patients had a sufficient primary/secondary prophylaxis. N = 14 patients had a sufficient
secondary prophylaxis at the time point of hospital discharge. TIPS implantation was
performed in n = 4 (23,5%) patients and n = 1 preexisting TIPS was reopened.
Conclusion:
During the first year of observation, we documented an expected number of AVB at our
center. Three failures to control bleeding were observed, of which all patients died
during follow up. A high percentage of cirrhotic patients isn't on sufficient prophylaxis
until the first bleeding episode. TIPS implantation is regularly performed for secondary
prophylaxis. Since 01/19 we include patients with elective elastic band ligations
as well. Extension to other centers is planned.
