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Abstract

early re-bleed and mortality in cirrhotic patients with variceal bleed. Aim: To study whether fibroscan can predict early re-bleed (within 5 days) and mortality at 6 weeks in cirrhotic patients presenting with variceal bleed. Material and method: In 86 patients who were presented with variceal bleed during the period from January 2012 to September 2013 to a tertiary care institute, factors predicting rebleed within 5 days and mortality at 6 weeks were studied. Thirty three patients were excluded due to various reasons including ascites, bilirubin >5 mg%, AST or ALT level >5 time ULN or hepatocellular carcinoma. Results: In this prospective study, it was observed that patients who developed rebleed were having significant difference in platelet count, CTP score, MELD score and fibroscan values. The mean platelet count (33666.67 vs. 83772.73; p value<0.002), mean CTP score (11.67 vs. 7.80; p<0.001), mean MELD score (7.80 vs. 5.29 p<0.001), mean fibroscan value (70.68 vs. 32.71 p<0.001). Mean platelet count, CTP score, MELD score and fibroscan values were compared between survivors and nonsurvivors after 6 weeks of bleed. Mean platelet count, mean CTP score, mean MELD score were significantly different in two groups i.e., (84585.37 vs. 36181.82; p<0.001), (7.68 vs. 11.18; p<0.001), (13.78 vs. 25.0; p<0.001) and (33.06 vs. 59.84; p<0.001) respectively. Conclusion: Fibroscan can predict early rebleed and mortality at six week in patients with variceal bleed but has few limitations. Clinical predictors including CTP and MELD score were found to be equally useful.

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