Effect of esophageal and gastric variceal bleeding on death outcome within one year in patients with liver cirrhosis and analysis of related factors: based on Propensity Score Matching postprint

Abstract: Background Esophageal and gastric variceal bleeding (EGVB) is one of the most common and dangerous complications of liver cirrhosis. However, whether EGVB affect the mortality of patients with cirrhosis during 1 year remains unclear. Objective To illustrate the influence factors of EGVB on the death of patients with liver cirrhosis within 1 year and further provide guidance for follow-up. Methods The clinical data of cirrhotic patients admitted to the Affiliated Changsha Central Hospital were collected from January 2015 to May 2021. Patients with liver cirrhosis were divided into two parts: EGVB group and control group without bleeding. Logistic Regression Analysis was conducted for screening factors affecting the death of patients during 1 year. Furthermore, the covariates of equilibrium between the two group were balanced by 1:2 Propensity Score Matching (PSM). Then, Univariate and Multivariate Logistic Regression were applied to identify the risk factors of death. Results Among 812 patients with cirrhosis included, 158 (19.5%) cases were diagnosed with EGVB, and other 654 (80.5%) cases had no EGVB. The 1-year mortality of EGVB and control group was 13.3% and 13.9%. There was no difference in 1-year mortality between the two groups. Before matching, Logistic regression analysis showed that serum sodium level [OR=0.95, 95%CI(0.90-0.99)] and Albumin level [OR=0.95, 95%CI(0.91-0.99)] were associated with decreased risk of 1-year death (P<0.05), while age [OR=1.04, 95%CI(1.02-1.06)] and hepatic encephalopathy (grade III-IV) [OR=3.72，95%CI(1.21-11.37)]were associated with increased risk (P<0.05). After matching, there was 145 cases in EGVB group and 290 cases in control group, and that 1-year mortality of both groups was 12.4%. Logistic regression analysis revealed that blood urea nitrogen (BUN) [OR=1.15, 95%CI(1.02-1.29)] was an independent risk factor for death during 1 year in EGVB group, while age [OR=1.09, 95%CI(1.04-1.14)] and neutrophil count/lymphocyte count (NLR) [OR=1.09，95%CI(1.00-1.18)] acted as the independent risk factor in control group without bleeding. Conclusion Whether EGVB happens or not has no obvious effect on the 1-year mortality of cirrhosis patients. However, there were considerable discrepancies of risk factors affecting the 1-year death between the two groups, which provides a new reference for clinical follow-up and treatment of patients with liver cirrhosis.