Risk factors for predicting in-hospital rebleeding following endoscopic variceal sclerotherapy

Background: This study aimed to exam the clinical risk factors of in-hospital variceal rebleeding during treatment intervals using endoscopic variceal sclerotherapy (EVS) in patients with esophageal variceal bleeding. Methods: This retrospective study included 204 cirrhosis patients with esophageal varices who received elective or emergency endoscopic sclerotherapy to prevent bleeding at the Chinese PLA General Hospital between December 2013 and June 2015. In-hospital early rebleeding was determined using endoscopy and treated using EVS. Results: The incidence of in-hospital rebleeding after EVS was 4.9%. Stepwise multivariate logistic regression analysis showed that varices erosion (OR 10.27, 95% CI 1.72-59.01, P=0.0128), varices size (OR 4.00, 95% CI 1.01-18.11, P=0.0490) and maximum sclerosing-agent volume per session (OR 1.16, 95% CI 1.04-1.32, P=0.0037) were independent risk factors for in-hospital rebleeding after EVS treatment. Patients with in-hospital rebleeding had a longer mean hospital stay (31.50 ± 11.85 vs. 20.50 ± 9.24 days; P=0.0004), higher total hospitalization costs (92217 ± 55518 vs. 34104 ± 21523 RMB; P<0.0001), and higher blood transfusion volume (1681 ± 1700 vs. 194 ± 141 ml; P<0.0001) than did non-rebleeding patients. Conclusions: In-hospital rebleeding after EVS during treatment intervals is mainly affected by varices erosion, varices size and maximum sclerosing-agent volume per session.