ANALYSIS OF TREATMENT OUTCOMES FOR BLEEDING FROM ESOPHAGEAL AND GASTRIC VARICES

Abstract

Introduction. Bleeding from esophageal and gastric varices (EGV) is one of the most life-threatening complications of liver cirrhosis and portal hypertension, associated with high mortality, especially in cases of late diagnosis and advanced hepatic insufficiency. Aim. To evaluate the clinical characteristics and treatment outcomes of patients with EGV bleeding treated at the Surgical Department of the Emergency City Hospital in Almaty from 2022 to 2024. Materials and Methods. Тhe study included 162 patients. Clinical parameters, severity of cirrhosis (Child–Pugh score), MELD index, endoscopic classification of varices (JGES), and treatment outcomes were analyzed. Descriptive statistics, Student’s t-test, χ²-test, and one-way ANOVA were used. Odds ratios (OR) with 95% confidence intervals were calculated to assess risk factors for rebleeding. A p-value < 0.05 was considered statistically significant. Results. Among 162 patients, males predominated (55.6%), with a mean age of 54.3 ± 11.2 years. Anemia (<70 g/L) was detected in 62.3%. II–III degree varices were diagnosed in 95.1%, and Child–Pugh classes B and C were present in 69.7%. Early ligation (<24 hours) reduced rebleeding to 2.3%, compared to 12.5% with delayed intervention (OR = 2.32); presence of red color signs (RCS) increased rebleeding risk to 17.9% (OR = 6.51). Overall mortality was 4.32%, postoperative mortality — 1.2%; all fatal outcomes occurred in patients with severe hepatic dysfunction. Conclusions. EGV bleeding remains a severe complication of cirrhosis requiring prompt diagnosis and active treatment. Early endoscopic ligation effectively reduces the risk of rebleeding and mortality. The presence of RCS and advanced variceal grade are significant predictors of poor prognosis.