A CROSS-SECTIONAL STUDY ON BACTEREMIA AS A RISK FACTOR FOR VARICEAL UPPER GASTROINTESTINAL TRACT BLEEDING IN CIRRHOTIC PATIENTS

Main Article Content

Murad Baig
Mashhood Sulaman
Muhammad Muizz Hassan
Ahmed Aftab
Akashnath Kivalur Ganeshanath
Muhammad Munawar
Saifullah Syed
Kamel J. K. Walwil
Jumana Abdelrahman Diab
Hosam Alazazzi

Keywords

Cirrhosis, Bacteremia, Variceal Bleeding, Risk factor

Abstract

Background and Aim: Rupture and bleeding from gastroesophageal reflux veins (GEVs) represent major complications for individuals with chronic liver disease (CLD), often leading to high mortality. The present study aimed to evaluate the bacteremia as a risk factor in cirrhotic patients suffering from variceal upper gastrointestinal tract bleeding.


 Patients and Methods: This cross-sectional study investigated 88 cirrhotic patients in the Department of Internal Medicine, Tertiary Care Hospital, Lahore from January 2022 to April 2024. Patients aged 20 to 60 years of either gender with liver cirrhosis disease were included. All the patients were grouped into three groups; Group-I (first attack), Group-II (recurrent attack), and Group-III (control or no history of variceal bleeding).  Eligible patients underwent history taking, complete physical examination, and laboratory investigations. Upper GI endoscopy, pro-calcitonin level measurement in blood, and blood culture were done.  Data analysis was done using SPSS version 26.


 Results: The overall mean age was 52.8 ± 8.62 years. Out of 88 patients, there were 54 (61.4%) male and 34 (38.6%) female. Patient’s distribution in groups were as follows; Group-I 32 (36.4%), Group-II 32 (36.4%), and Group-III 24 (27.2%). The incidence of positive blood culture such as Escherichia coli, Staphylococcus auerus, and Klebsiella in Group-I, Group-II, and Group-III was 15 (46.9%), 20 (62.5%), and 6 (25%), respectively whereas the rate of positive Procalcitonin (ng/ml) was 14 (43.8%), 19 (59.4%), and 5 (20.8%) respectively. The highest percentage of positive blood cultures was observed in Group-II, followed by Group-I, and a control group and, Patients with recurrent venous hemorrhage showed statistically higher PCT values ​​compared with first-time venous hemorrhage and the control group.


 Conclusion: The present study observed that bacteremia and elevated procalcitonin levels are risk factors in patients with cirrhosis. Procalcitonin may serve as a surrogate biomarker for variceal bleeding and bacteremia.

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