A CROSS-SECTIONAL STUDY ON BACTEREMIA AS A RISK FACTOR FOR VARICEAL UPPER GASTROINTESTINAL TRACT BLEEDING IN CIRRHOTIC PATIENTS
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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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Murad Baig
Paediatrics Department, Shaukat Khanum Hospital, Lahore - Pakistan
Mashhood Sulaman
House Officer, CDA Hospital, Islamabad - Pakistan
Muhammad Muizz Hassan
Senior House Officer, General Medicine Department, University of Limerick Hospitals Group. Limerick – Ireland
Ahmed Aftab
Medical Officer, DHQ Hospital, Bagh - AJK
Akashnath Kivalur Ganeshanath
Royal College of Surgeons Ireland- Medical University of Bahrain
Muhammad Munawar
Department of Internal Medicine, CMH, Kharianm - Pakistanc
Saifullah Syed
Royal College of Surgeons in Ireland, Dublin - Ireland
Kamel J. K. Walwil
Royal College of Surgeons in Ireland - Bahrain
Jumana Abdelrahman Diab
Royal College of Surgeons in Ireland - Bahrain
Hosam Alazazzi
Royal College of Surgeons in Ireland - Bahrain