Gastroesophageal variceal hemorrhage in patients with chronic liver diseases attending university of Gondar Specialized comprehensive hospital in Ethiopia: Institutional based cross-sectional study.

ABSTRACT

Introduction: Rupture and bleeding from Gastroesophageal Varices (GEVs) are major complications among patients with chronic liver disease (CLD) and are associated with a high mortality rate. Hence, identifying factors of Gastroesophageal Variceal Hemorrhage (GEVH) is essential for the management and prevention of this fatal outcome. Objective: To assess the prevalence of GEVH and its associated factors among patients with CLD in Northwest Ethiopia. Methods: An institutional based cross-sectional study design was employed on a total of 262 patients. The data was entered into Epi-Data version 3.1, and then exported and analyzed using STATA version 14. The distribution of variables was checked using kolmogorov-smirnov test. Bivariable logistic regression model was fitted to select variables for multivariable analysis. In the final model, adjusted odds ratio with 95% confidence level and P-value less than 0.05 were used to assess degree of association. Results: The mean age of the study subjects was found to be 37.76 years (SD ± 11.62). The prevalence of GEVH was found to be 52% (95% CI 49.6-54.2). Patients with grade F2 and F3 varices have 3.41 times (AOR 3.41, 95% CI 2.33-4.74) and 3.33 times (AOR 3.33, 95% CI 2.55-4.12) higher odds of bleeding, respectively. Patients not taking beta blocker have 2.38 times (AOR 2.38, 95% CI 1.82-3.90) increased odds of bleeding. Patients with more than three years of duration of illness have 2 times (AOR 2.19, 95% CI 1.39-3.99) increased odds of bleeding. Patients with platelet number less than 50,000/µl have 3.46 times (AOR 3.46, 95% CI 2.55-4.17) higher odds of bleeding. Conclusion: GEVH is found to be high in patients with CLD seen at university of Gondar Hospital. Higher grade of varices, non-use of beta blockers, presence of infection, platelet number and age are associated with higher occurrence of bleeding, pointing the possibility of averting this fatal complication, for most of the identified factors are preventable.