| Natural history of gastric varices and risk factors for bleeding |
| Choong Hyeon Lee, M.D., Joon Hyoek Lee, M.D., Ph.D., Yong Sung Choi, M.D.,
Seung Woon Paik, M.D., Dong Hyun Sinn, M.D., Choon Young Lee, M.D.,
Kwang Cheol Koh, M.D., Geum-Youn Gwak, M.D., Moon Seok Choi, M.D.,
Byung Chul Yoo, M.D. |
| Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea |
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| ABSTRACT |
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Background/Aims
Gastric varices (GV) are one of the most serious complications of portal hypertension,
but there is limited information on the clinical course of GV in Korea. The aim of this study was to elucidate
the natural history of GV bleeding in Korean patients. Methods: Of 604 patients with GV diagnosed between
May 1995 and May 2005 at the Samsung Medical Center, 237 patients without a history of variceal bleeding
or previous intervention for varices were investigated. The cumulative incidence rates of GV bleeding,
long-term survival rates, and risk factors for GV bleeding were evaluated. Results: The cumulative incidence
rates of GV bleeding were 4.8%, 19.9%, and 23.2% at 1, 3, and 5 years after diagnosis, respectively. The
overall survival rates were 88.6%, 53.2%, and 37.2% at 1, 5, and 10 years. In the univariate analysis, fundal
varices, large (F3) GV, red color sign, and poor liver function (Child-Pugh class B or C) were significant risk
factors for GV bleeding. In the multivariate analysis, large GV (hazard ratio 2.49) and poor liver function
(hazard ratio 3.95) were the independent risk factors. Conclusions: GV bleeding was more frequent in patients
with fundal varices than in patients with type 1 gastroesophageal varices, and large GV and poor liver function
were risk factors for GV bleeding. Close observation and prophylaxis for variceal bleeding might be warranted
in high-risk patients. (Korean J Hepatol 2008;14:331-341) |
| KeyWords:
Esophageal and Gastric Varices; Natural History; Hemorrhage; Risk Factors; Liver Cirrhosis |
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