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Burden and determinants of upper gastrointestinal bleeding in cirrhotic patients: evidence from Sub-Saharan Africa,
Bekele Taye1, Yihealem Yabebal Ayele2, Dessalegne Nigatu Achenef3
1Department of Internal Medicine, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia. bekeletaye414@gmail.com.
Insights
Upper gastrointestinal bleeding (UGIB) is common in Ethiopian cirrhotic patients. Long disease duration, low platelets, and lack of endoscopy increase UGIB risk, highlighting the need for screening and monitoring.
Area of Science:
- Gastroenterology
- Hepatology
- Internal Medicine
Background:
- Upper gastrointestinal bleeding (UGIB) is a severe complication of liver cirrhosis, contributing significantly to hospital admissions and mortality.
- Evidence on UGIB prevalence and its determinants in Ethiopian cirrhotic patients is limited.
Purpose of the Study:
- To determine the prevalence of UGIB.
- To identify associated factors of UGIB in cirrhotic patients in Northwest Ethiopia.
Main Methods:
- A facility-based cross-sectional study was conducted with 256 cirrhotic patients.
- Data were collected using a structured checklist and analyzed with logistic regression.
- Prevalence and associated factors of UGIB were determined.
Main Results:
- The prevalence of UGIB was 46.1%.
- Significant factors included illness duration >24 months, low platelet counts (thrombocytopenia), and absence of prior endoscopy.
- Specific odds ratios were calculated for each associated factor.
Conclusions:
- UGIB prevalence is high in cirrhotic patients, often due to esophageal varices.
- Long disease duration, thrombocytopenia, and lack of endoscopic screening are key risk factors.
- Early endoscopic screening and monitoring of platelet counts are crucial for reducing UGIB complications.
Introduction:
Upper gastrointestinal bleeding (UGIB) is a serious and life-threatening complication of liver cirrhosis, contributing a notable percentage to emergency admissions, morbidity, and mortality. There is limited evidence regarding UGIB prevalence and determinants among cirrhotic patients in Ethiopia, particularly in the study setting.
Objective:
To determine the magnitude of UGIB and its associated factors in cirrhotic patients visiting public hospitals in Northwest Ethiopia, 2024.
Methods:
A facility-based cross-sectional study was performed in 256 cirrhotic patients from November 2024 to January 2025. Participants were enrolled through consecutive sampling. Data were gathered with the help of a structured checklist, entered into Epi Data version 3.1, and analyzed using SPSS version 27.0. Descriptive statistics presented patient characteristics. Bivariate and multivariate logistic regression analyses were performed to determine factors related to UGIB. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were presented, and the statistical significance level was p < 0.05.
Results:
UGIB prevalence was 46.1%. Significantly associated factors were illness duration > 24 months (AOR = 2.42; 95% CI: 1.34-4.35), platelet count 50,000-100,000/µL (AOR = 1.90; 95% CI: 1.23-3.61), platelet count < 50,000/µL (AOR = 5.27; 95% CI: 2.63-10.56), and absence of prior endoscopy (AOR = 3.62; 95% CI: 1.95-6.69).
Conclusion:
UGIB prevalence was high in this cirrhotic population, primarily due to esophageal varices. Long duration of the disease, thrombocytopenia, and absence of endoscopic screening were significant risk factors identified. These findings underscore the importance of early endoscopic screening, thrombocytopenia monitoring, and the expansion of preventive services to reduce UGIB-related complications in cirrhotic patients.
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