Bleeding Control and Bacterial Infection

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Dig Dis Sci 2001 Dec;46(12):2752-7 Presence of bacterial infection in bleeding cirrhotic patients is independently associated with early mortality and failure to control bleeding. Vivas S, Rodriguez M, Palacio MA, Linares A, Alonso JL, Rodrigo L Gastroenterology Service, Hospital Central de Asturias, Oviedo, Spain. [Medline record in process] Bacterial infection is strongly associated with gastrointestinal bleeding in cirrhotic patients and seems to be related with the failure to control bleeding. The aims of this study were to assess the influence of infections on the failure to control bleeding and death in cirrhotic patients without antibiotic prophylaxis. Ninety-one consecutive bleeding cirrhotic patients were analyzed. Bleeding was managed using somatostatin with sclerotherapy for active bleeding. Screening for bacterial infection (analysis and culture of blood, urine, ascitic and other fluids, together with chest radiography) was made at time 0 and when clinical signs suggested infection. The cause of bleeding was variceal in 72 (79%) patients. Failure to control bleeding occurred in 24 (26%) patients, and 10 (11%) of the patients died. Compared with the group without infection, failure to control bleeding (65% vs 15%; P < 0.001) and mortality (40% vs 3%; P < 0.001), were observed more frequently in patients with infection. Multivariate analysis showed that bacterial infection (OR = 9.7; P < 0.001) and the presence of shock (OR = 3.5; P < 0.05) were independently associated with failure to control bleeding. Bacterial infection (OR = 12.6; P < 0.01), encephalopathy (OR = 6.9; P < 0.05), and shock (OR = 5.8; P < 0.05) were identified as predictive of death. In conclusion, in bleeding cirrhotic patients bacterial infection is associated with failure to control bleeding as well as mortality. PMID: 11768269, UI: 21618373 --------------------------- Sheree Martin mailto:[email protected] Co-Owner Hepatitis B Info & Support List http://www.geocities.com/Heartland/Estates/9350/hblist.html Hepatitis Glossary:http://www.geocities.com/Mamablondie/hepterms.html _______________________________________________________________ A blank message to these addresses performs the following - [email protected] gets you on the list. [email protected] gets you off the list. [email protected] toggles you to/from the fancy digest version. [email protected] toggles you to/from the vacation list. [email protected] posts your message to the list.