Factor No. of patients No. of patients who bled P-value* No. of patients who died P-value* Sex Male 222 51 <0.001 85 0.470 Female 82 4 - 26 - Age (years) </=51 150 26 0.377 43 0.001 >/=52 154 29 - 68 - Heavy alcohol intake Absent 172 20 <0.001 54 0.049 Present 132 35 - 57 - Cause of liver cirrhosis Alcohol 65 20 0.019 19 0.751 Hepatitis B virus 192 29 - 73 - Hepatitis C virus 31 5 - 12 - Other 16 1 - 7 - Form of varix Small 164 11 <0.001 49 0.009 Large 140 44 - 62 - Red color signs Absent 245 26 <0.001 82 0.021 Present 59 29 - 29 - Location of varix Inferior 128 14 <0.001 40 0.136 Median 140 30 - 56 - Superior 36 11 - 15 - Color of varix Blue 179 35 0.414 68 0.241 White 125 20 - 43 - Gastric varix Absent 228 31 <0.001 80 0.214 Present 76 24 - 31 - Albumin (g/dL) </=3.6 164 34 0.034 77 <0.001 >3.6 140 21 - 34 - Bilirubin (mg/dL) </=1.5 150 24 0.068 39 0.003 >1.5 154 31 - 72 - Prothrombin time (s) </=13.5 160 34 0.412 47 <0.001 >13.5 144 21 - 64 - Ascites Absent 158 18 <0.001 34 <0.001 Present 146 37 - 77 - Encephalopathy Absent 279 51 0.506 94 <0.001 Present 25 4 - 17 - Child grade A 153 23 0.003 28 <0.001 B 113 21 - 56 - C 38 11 - 27 - Platelet (103/mm3) </=84.5 152 30 0.242 66 0.005 >84.5 152 25 - 45 - AST (IU/L) </=45 57 9 0.431 13 0.020 >45 247 46 - 98 - DM Yes 43 11 0.177 19 0.257 No 261 44 - 92 - HTN Yes 10 3 0.251 4 0.671 No 294 52 - 107 - GB stone Yes 8 2 0.841 1 0.139 No 296 53 - 110 - *Log-rank test. AST, aspartate aminotransferase; DM, diabetes mellitus; GB, gallbladder; HTN, hypertension.
Factors Hazard ratio (95% confidence interval) P-value Alcohol ingestion (heavyvsnon-heavy) 2.29 (1.32-3.97) 0.003 Form of varix (largevssmall) 3.26 (1.52-6.98) 0.002 Red color sign (presentvsabsent) 4.26 (2.31-7.87) <0.001
Subgroups No. of patients (bleeding) Incidence of first bleeding (%) Incidence of bleeding related deaths (%) 1 year 2 years 3 years 5 years 1 year 2 years 3 years 5 years Low-risk group 205 (14) 1.0 4.4 8.0 11.8 0.0 1.3 2.9 4.2 High-risk group 68 (22) 12.7 35.9 44.9 44.9 0.0 7.6 12.8 12.8 Very-high-risk group 31 (19) 34.9 57.3 75.6 87.8 3.4 13.9 25.8 25.8 Risk groups were defined by three risk components of a varix larger than F1, positive red color sign and the presence of heavy alcohol consumption. Those with all of three risk components were allocated to the 'very-high-risk group', those with two components to the 'high-risk group', and those with one component or none to the 'low-risk group'.
Factor No. of patients No. of deaths (%) P-value* Sex Male 51 12 (24) 0.266 Female 4 2 (50) - Age (years) </=53 28 6 (21) 0.485 54 27 8 (30) - Heavy drinking Absent 24 5 (21) 0.489 Present 31 9 (29) - Cause of cirrhosis Alcohol 20 5 (25) 0.364 Hepatitis B virus 29 7 (24) - Hepatitis C virus 5 1 (20) - Other 1 1 (100) - Form of varices Small 2 1 (50) 0.448 Large 53 13 (25) - Red color signs Absent 4 0 (0) 0.562 Present 51 14 (28) - Location of varices Inferior 5 1 (20) 0.889 Median 27 7 (26) - Superior 23 6 (26) - Color of varices Blue 24 7 (29) 0.578 White 31 7 (23) - Gastric varices Absent 27 8 (30) 0.485 Present 28 6 (21) - Albumin (g/dL) </=3.1 25 10 0.032 >3.1 30 4 - Bilirubin (mg/dL) </=1.8 26 1 <0.001 >1.8 29 13 - Prothrombin time (s) </=13.7 28 6 0.547 >13.7 27 8 - Ascites Absent 21 2 (10) 0.054 Present 34 12 (35) - Encephalopathy Absent 43 7 (16) 0.003 Present 12 7 (58) - Child grade A 16 0 (0) <0.001 B 19 3 (16) - C 20 11 (55) - Platelet (103/mm3) </=77 28 11 (30) 0.029 >77 27 3 (9) - AST (IU/L) </=78 29 4 (14) 0.061 >78 26 10 (38) - PVT Absent 51 10 (20) 0.003 Present 4 4 (100) - *Comparison of proportions was performed using the chi-squared test or the Fisher's exact test when the number in a cell was </=5.
Tumor thrombus in main portal vein. AST, aspartate aminotransferase; PVT, portal vein thrombus.
Group Cause of death (%) Hepatic failure Hepatocellular carcinoma Variceal bleeding Hepatorenal syndrome Infection Other Total Cause of liver cirrhosis Alcohol 10 (43) 1 (4) 6 (26) 2 (9) 2 (9) 2 (9) 23 (100) Non-alcohol 40 (45) 23 (26) 11 (13) 6 (7) 3 (3) 5 (6) 88 (100) Risk of variceal bleeding Low risk 36 (58) 11 (18) 5 (8) 3 (5) 2 (3) 5 (8) 62 (100) High or more risk 14 (29) 13 (27) 12 (24) 5 (10) 3 (6) 2 (4) 49 (100) Entire group 50 (45) 24 (22) 17 (15) 8 (7) 5 (5) 7 (6) 111 (100)
Factor No. of patients (deaths) Cumulative survival rates (%) P-value 1 year 2 years 3 years 4 years 5 years Variceal bleeding Absent 249 (72) 93.5 83.3 71.7 64.4 56.8 0.013 Present 55 (39) 94.6 78.2 54.6 42.9 33.0 - HCC Absent 264 (84) 93.1 81.8 70.3 62.4 54.6 0.031 Present 40 (27) 97.5 84.9 54.1 40.5 28.3 -
Group and factor Hazard ratio (95% CI) P-value Entire patient group Age (years) 1.02 (1.00-1.04) 0.038 Albumin (g/dL) 0.40 (0.27-0.58) <0.001 Ascites (presentvsabsent) 1.56 (1.00-2.44) 0.049 Encephalopathy (presentvsabsent) 1.84 (1.21-2.81) 0.005 Child-Pugh score 1.33 (1.22-1.45) <0.001 Platelet (103/mm3) 0.93 (0.88-0.99) 0.012 HCC (presentvsabsent) 2.64 (1.62-4.31) <0.001 Variceal bleeding (presentvsabsent) 3.87 (2.22-6.73) <0.001 Time after variceal bleeding (months) 0.97 (0.95-0.99) 0.003 Alcoholic cirrhosis Encephalopathy (presentvsabsent) 8.61 (2.60-28.46) <0.001 Variceal bleeding (presentvsabsent) 26.03 (7.73-87.68) <0.001 Time after variceal bleeding (months) 0.94 (0.89-0.98) 0.009 Non-alcoholic cirrhosis Age (years) 1.03 (1.00-1.05) 0.007 Albumin (g/dL) 0.21 (0.14-0.31) <0.001 HCC (presentvsabsent) 2.90 (1.75-4.83) <0.001 Variceal bleeding (presentvsabsent) 3.20 (1.61-6.36) <0.001 Time after variceal bleeding (months) 0.97 (0.95-0.99) 0.040 Child-Pugh grade A HCC (presentvsabsent) 4.63 (1.76-9.03) <0.001 Form of varix (largevssmall) 2.54 (1.13-5.70) 0.020 Child-Pugh grade B HCC (presentvsabsent) 3.22 (1.66-6.25) <0.001 Variceal bleeding (presentvsabsent) 5.70 (2.64-12.33) <0.001 Time after variceal bleeding (months) 0.94 (0.90-0.98) 0.003 Child-Pugh grade C Age (years) 1.04 (1.00-1.09) 0.038 Child-Pugh score and its five component variables were analyzed separately on the basis of two Cox-Oakes' models. CI, confidence interval.