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All Journal Proceedings of the International Conference on Applied Science and Health Indonesian Journal of Health Development eJournal Kedokteran Indonesia The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Jurnal ARSI : Administrasi Rumah Sakit Indonesia
Eka Ginanjar
Divisi Kardiologi Departemen Ilmu Penyakit Dalam FKUI/RSCM, Unit Pelayanan Jantung Terpadu RSCM
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Variabel dan Model Prediktor Perdarahan Varises Esofagus Berulang pada Pasien Sirosis Hati di RSUPN Dr. Cipto Mangunkusumo Sari, Ifani Media; Kurniawan, Juferdy; Kalista, Kemal Fariz; Rizka, Aulia; Ginanjar, Eka; Nasution, Sally Aman; Nainggolan, Leonard, MD. Internal medicine, Tropic-Infection spesialist; Koesnoe, Sukamto
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Introduction. Liver cirrhosis is a chronic condition associated with severe complications, including esophageal variceal bleeding, which carries high morbidity and mortality rates. Approximately 60% of patients with cirrhosis experience recurrent bleeding within one year, with a mortality rate of 20–60% within six weeks after the initial bleeding episode. Therefore, identifying predictors of recurrent bleeding is essential for improving preventive strategies. This study aimed to identify predictors of recurrent esophageal variceal bleeding in patients with liver cirrhosis and to develop a predictive model. Methods. This retrospective study included 220 patients with liver cirrhosis and a history of esophageal variceal bleeding based on medical record data. The variables analyzed included age, platelet count, red color sign, spontaneous bacterial peritonitis, splenomegaly, number of endoscopic variceal ligation (EVL) bands, portal hypertensive gastropathy, and Child–Pugh score. Statistical analyses were performed to identify independent predictors and to develop a prediction model. Results. Recurrent esophageal variceal bleeding occurred in 33.6% of patients. Patients with recurrent bleeding were more likely to be male, younger, have hepatitis B as the underlying etiology, a Child–Pugh score ≥7, a platelet count <150,000/µL, and ≥3 EVL bands placed during treatment. Bivariate analysis demonstrated that a Child–Pugh score ≥7, platelet count <150,000/µL, ≥3 EVL bands, the presence of a red color sign, and splenomegaly were significantly associated with recurrent esophageal variceal bleeding in patients with liver cirrhosis. The final prediction model consisted of three variables: Child–Pugh score, platelet count, and number of EVL bands, with a maximum total score of 4 points. The model demonstrated good predictive performance, with an area under the receiver operating characteristic curve (AUC) of 0.81. Conclusions. The predictors of recurrent esophageal variceal bleeding in patients with liver cirrhosis were Child–Pugh score, platelet count, and the number of EVL bands. The resulting prediction model demonstrated good statistical performance and may be useful for risk stratification in clinical practice.
Co-Authors Agnes Kurniawan Amal C Sjaaf Amal Sjaaf Antono, Akbarbudhi Aprildah Nur Sapardin Ardani, Yanuar Ari Fahrial Syam Aulia Rizka, Aulia Birry Karim Ceva W. Pitoyo Diah Pravita Sari Dono Antono E Mudjaddid E Mudjaddid, E E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Em Yunir, Em Erni Juwita Nelwan, Erni Juwita Funay, Prijander L B Hakim, Manfaluthy Harry Isbagio Hendra Perkasa Heppi Kartika Rahmawati Ika Prasetya Wijaya Ikhwan Rinaldi Irman Firmansyah Juferdy Kurniawan Kemal Fariz Kalista, Kemal Fariz Kuntjoro Harimurti Muhadi Muhadi Muhadi Muhadi, Muhadi Nainggolan, Leonard, MD. Internal medicine, Tropic-Infection spesialist Prijander Lombardia Funay Pringgodigdo Nugroho, Pringgodigdo Ratna Agtasari Rudi Putranto Sally Aman Nasution Sally Aman Nasution, Sally Aman Sari, Diah Pravita Sari, Ifani Media Setyawan, Wawan Simon Salim Sjaaf, Amal C Sjaaf, Amal Chalik Sukamto Koesnoe Sulistianingsih, Dyah Purnamasari Teguh Hardjono Vika Wahyudi Anggiri Wahyu Sulistiadi Wahyu Sulistyadi Wahyu Sulistyadi Yulianto Yulianto Yusuf Subekti