Analysis of risk factors associated with the first complication of gastrointestinal bleeding in hepatitis B cirrhosis

Corresponding author: yangzhengwu, yzwsdta@163.com

DOI: 10.12201/bmr.202504.00075

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  Abstract: Objective：To investigate the risk factors for first gastrointestinal bleeding in cirrhotic patients with hepatitis B and to construct a predictive model. Methods：Patients were collected with definite diagnosis of hepatitis B cirrhosis in the Second Affiliated Hospital of Shandong First Medical University from January 2022 to December 2024. Patients hospitalized for first gastrointestinal bleeding were also screened as the bleeding group and those who had not experienced gastrointestinal bleeding as the control group, and the general data of the patients in the bleeding and non-bleeding groups were compared,then analysis of possible risk factors affecting the first complication of upper gastrointestinal bleeding in patients with hepatitis B cirrhosis. The inclusion indicators were analyzed for differences and all statistical analyses were performed using SPSS 27.0 software. The chi-square test was used for dichotomous variables; continuous variables were tested for normality, and t-tests were used for those that conformed to normal distribution, and nonparametric rank-sum tests were used for hierarchical variables. Meaningful indicators were included in logistic regression analysis to screen independent risk factors for gastrointestinal bleeding, and ROC curves were constructed for the first complication of gastrointestinal bleeding in hepatitis B cirrhosis. Results：Univariate analysis suggested that liver function grade C, low level of RBC, PLT, FIB, ALB, PTA and prolonged PT time, high ratio of INR, internal diameter of portal vein trunk and severe esophageal varices were the risk factors for the first complication of gastrointestinal hemorrhage in cirrhosis of hepatitis B. The difference was statistically significant (p < 0.05); multifactorial analysis showed that RBC, portal vein internal diameter and severe esophagogastric fundal varices were hepatitis B cirrhosis complicated by upper gastrointestinal bleeding. Conclusion：When RBC <3.25*109/L, portal vein internal diameter >14.5 mm and the presence of severe esophageal varices joint diagnosis of hepatitis B cirrhosis with first complication of the upper gastrointestinal tract has a greater predictive value, and should be intervened in a timely manner.

  Key words: hepatitis B cirrhosis; gastrointestinal bleeding; risk factors; predictive modeling

  Submit time: 29 April 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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