The effect of clinical, etiological and endoscopic differences on mortality in esophagus varicose bleeding

Aim: It was aimed to evaluate the clinical features, etiological differences, endoscopic findings and the effects of the treatments applied on mortality in patients with esophageal variceal bleeding. Materials and Methods: In this study, patients diagnosed with cirrhosis, HCC and esophageal variceal bleeding between 01.01.2010 and 31.12.2020, who were followed up and treated in the Department of Gastroenterology, Department of Internal Medicine of Karadeniz Technical University were examined. Laboratory values, clinical features, accompanying comorbidities, etiological differences, endoscopic treatments, date of death of the patients who died were evaluated retrospectively in 155 patients aged 18 years and older who had esophageal variceal bleeding. Results: Of the 155 patients included in the study who had esophageal variceal bleeding, 151 were cirrhotic and 4 were non-cirrhotic. Looking at the histories of the patients, 75 had diabetes, 58 had hypertension, 15 had heart failure, and 22 had CKD. 9 of the patients had F1, 55 had F2, and 91 had F3 varicose veins. When the etiologies were examined, it was seen that there were 33 patients with cryptogenic liver cirrhosis, 27 patients with HCV, 26 patients with HBV, 15 patients with NASH, and 14 alcohol-related patients; The examinations of 20 patients were insufficient. 49 patients were Child A, 70 patients were Child B, 36 patients were Child C; median MELD-Na score: 13, mean APRI score: 2.55, mean FIB-4 score: 8.73, mean Hemoglobin: 10.56 g/dl, mean PLT: 114.1*10^3/ul . When the patients who had esophageal variceal bleeding and died were examined, death was seen on average 831 days after the first variceal bleeding. Conclusion: When the clinical, etiological and endoscopic features of the patients in our study who had esophageal variceal bleeding were examined; The effects of complications such as gender distribution, age, ascites, peritonitis, hepatic encephalopathy and hepatorenal syndrome on mortality were similar to those in the literature; the most common etiology was different from the literature. As in the literature, the cause of portal hypertension in most of our patients who had esophageal variceal bleeding is liver cirrhosis. Because of the significant effects of complications such as ascites, peritonitis, hepatic encephalopathy and hepatorenal syndrome on mortality, it is extremely important to prevent and treat the development of these complications in patients with esophageal variceal bleeding. Esophageal varices bleeding should definitely be considered in patients with cirrhosis who have had gastrointestinal bleeding. Keywords: Cirrhosis, Esophageal Varices, Variceal Bleeding, Portal Hypertension, Liver Cirrhosis, Endoscopy, Hepatitis, Mortality