Risk factors for glue extrusion bleeding after endoscopic therapy for esophagogastric variceal bleeding

Objective To investigate the risk factors for glue extrusion bleeding after endoscopic tissue adhesive injection for the treatment of esophagogastric variceal bleeding. Methods A total of 416 patients with liver cirrhosis complicated by esophagogastric variceal bleeding or a past history of bleeding who were admitted to Beijing Ditan Hospital, Capital Medical University, from October 2008 to January 2016 were enrolled. A retrospective analysis was performed for their clinical data, including sex, age, etiology, routine blood test results, hepatic and renal function, electrolytes, blood lipids, coagulation, diameter of the portal vein, anteroposterior diameter of the spleen, Child-Pugh score, and volume of tissue adhesive injection. The t-test was used for comparison of continuous data between groups, and a multivariate logistic regression analysis was also performed. Results Of all patients, 59 experienced glue extrusion bleeding, resulting in an incidence rate of 14. 18% . The univariate analysis showed that there were significant differences in total bilirubin, direct bilirubin, total bile acid, Child-Pugh score, and volume of tissue adhesive injection between the patients with glue extrusion bleeding and those without ( t = 2. 54, 2. 85, 2. 35, 1. 03, and 4. 38, all P < 0. 05) . The multivariate logistic regression analysis showed that Child-Pugh score ( odds ratio[OR]= 2. 714, 95% confidence interval[CI]1. 600-4. 850, P = 0. 009) and volume of tissue adhesive injection ( OR = 2. 925, 95% CI 1. 762-5. 124, P = 0. 008) were independent risk factors for glue extrusion bleeding. Conclusion Patients with higher Child-Pugh score and volume of tissue adhesive injection tend to have a higher risk of glue extrusion bleeding.