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| Predictive Value of Coagulation Function and Nutritional Index on Prognosis in Patients with Esophageal Varices Bleeding Undergoing Endoscopic Variceal Ligation |
| YUAN Chengxue, et al |
| Chengdu Shangjin Nanfu Hospital/Sichuan University West China Hospital Shangjin Hospital Digestive Endoscopy Center, Sichuan Chengdu 610000, China |
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Abstract Objective: To analyze the predictive value of coagulation function and nutritional index on prognosis in patients with esophageal varices bleeding undergoing endoscopic variceal ligation(EVL). Methods: One hundred and fifty-two patients with esophageal variceal bleeding who underwent EVL in our department from December 2019 to December 2021 were divided into rebleeding group and non-rebleeding group according to the prognosis. The clinical data were compared between the two groups, and multivariate Logistic regression analysis was used to explore the independent predictors of early rebleeding. The area under the curve(AUC)of receiver operating curve(ROC) was performed to evaluate the predictive value of index for early postoperative rebleeding. Results: All patients successfully completed EVL, and the success rate of short-term hemostasis was 100%. The follow-up result showed that 15 patients(9.9%) had rebleed within 6 weeks after EVL, which occurred 15.3 days(4~36 days) after EVL. The incidences of Child-Pugh grade C, portal vein thrombosis, severe esophageal varices, the total number of ligation rings, prothrombin time(PT), activated partial thromboplastin time and total bilirubin level in rebleeding group were significantly higher than those in non-rebleeding group, and the levels of hemoglobin, platelet, albumin and prognostic nutritional index(PNI)score were significantly lower than that of non-rebleeding group(P<0.05). Multivariate logistic regression analysis showed that portal vein thrombosis, PT and PNI score were the independent predictors of early rebleeding after EVL (P<0.05). The result of ROC curve showed that the preoperative PT and PNI score of all patients had a high predictive value for early postoperative rebleeding, and their AUC (95% CI) were 0.751 (0.569 ～ 0.932) and 0.731 (0.466 ～ 0.974) respectively. Conclusion: PT and PNI score of patients with esophageal variceal bleeding before EVL were the independent predictors of postoperative early rebleeding, and they had a high predictive value for surgical prognosis.
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2023, Vol. 29 
