Long-term prognosis of patients with cirrhosis of the liver and upper gastrointestinal bleeding

Abstract

A study has been carried out on the 5-yr survival curves of 287 patients admitted with upper gastrointestinal bleeding and portal hypertension. In 78.7%, the cause of bleeding was from esophageal varices. Only 2.4% had noncirrhotic portal hypertension, and 80% were alcoholics. At 5 yr, the overall survival probability was 26.2%. The curve had three segments with survival rates of 69% at 2 wk and 46.6% at 12 months. According to Child's grade, the curves were very different at 2 wk, 12 months, and 60 months: Group A, 94.0, 78.0, and 51.8%; group B, 77.0, 46.0, and 32.2; group C, 52.0, 11.0, and 2.3%. The largest differences were observed in the first 2 wk immediately after the first bleeding. The recurrence of bleeding in a period of 6 months significantly decreased the survival. Age, as well as the introduction of prophylactic measures (propranolol or sclerotherapy), did not influence long-term survival. Alcohol abstinence was accompanied by better survival. This difference was due to the impact of abstinence only in group B patients.