{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:25:02Z","timestamp":1782451502291,"version":"3.54.5"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T00:00:00Z","timestamp":1554076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Upper gastrointestinal bleeding (UGIB) is a serious complication of portal hypertension in cirrhotic patients. The objective of this study is to identify the risk factors for morbidity and mortality occurring after an UGIB attack.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 1097 UGIB attacks in 690 patients with liver cirrhosis were studied. Their clinical, laboratory, and endoscopic data were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age 53.2\u00a0\u00b1\u00a010.6 (20\u201390) years, 78% men and the main cause of liver disease was hepatitis C (94.9%). Complications occurred after 467 attacks (42.6%): hepatic encephalopathy 31.4%, spontaneous bacterial peritonitis 18%, renal impairment 13.2%, and re\u2010bleeding in 7.8%, while 199 patients (18.1%) died. Complications followed 78.4% of bleeding from gastric varices, 75% of post\u2010interventional ulcers, 10.8% of peptic ulcers, and 5.9% of telangiectasias. By univariate analysis: packed red blood cells units transfused, transaminases, Child\u2013Pugh (CP), model of end\u2010stage liver disease (MELD), and albumin\u2013bilirubin (ALBI) scores, beside the presence of hepatocellular carcinoma (HCC), previous hemorrhage in the previous 6\u00a0months, and the source of bleeding, were associated with occurrence of complications. By multivariate analysis, independent predictors of complications were CP, MELD, and ALBI scores (odds ratio, 95% confidence interval: 5.63, 3.55\u20138.93; 1.15, 1.11\u20131.19; and 2.11, 1.4\u20133.19, respectively) beside the presence of HCC (4.89, 2.48\u20139.64). Mortality predictors were packed red blood cells units transfused (1.11, 1.01\u20131.24), CP (5.1, 1.42\u201318.25) MELD (1.27, 1.21\u20131.32) scores, and presence of HCC (6.62, 2.93\u201314.95).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>High CP, MELD, and ALBI scores beside the presence of HCC could predict poor outcome of UGIB. In the absence of these risk factors, early discharge could be considered if the source of bleeding is peptic ulcer or telangiectasia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14659","type":"journal-article","created":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T13:19:17Z","timestamp":1552569557000},"page":"1604-1610","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Upper gastrointestinal bleeding in Egyptian patients with cirrhosis: Post\u2010therapeutic outcome and prognostic indicators"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1542-0265","authenticated-orcid":false,"given":"Tamer R","family":"Fouad","sequence":"first","affiliation":[{"name":"Hepatology Department, National Liver Institute University of Menoufia  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Abdelsameea","sequence":"additional","affiliation":[{"name":"Hepatology Department, National Liver Institute University of Menoufia  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael","family":"Abdel\u2010Razek","sequence":"additional","affiliation":[{"name":"Hepatology Department, National Liver Institute University of Menoufia  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Attia","sequence":"additional","affiliation":[{"name":"Hepatology Department, National Liver Institute University of Menoufia  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwar","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Hepatology Department, National Liver Institute University of Menoufia  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1286-7616","authenticated-orcid":false,"given":"Khaled","family":"Metwally","sequence":"additional","affiliation":[{"name":"Hepatology Department, National Liver Institute University of Menoufia  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Naguib","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry Department, National Liver Institute University of Menoufia  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imam","family":"Waked","sequence":"additional","affiliation":[{"name":"Hepatology Department, National Liver Institute University of Menoufia  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13186"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800600817"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-008-0364-1"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(81)90144-X"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198412203112502"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(99)70455-5"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.07294.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2005.05.009"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510270504"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.137489"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.05.022"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800600817"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2003.50016"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.57.9151"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2004.30272.x"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.314"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2010.10.035"},{"key":"e_1_2_5_19_1","first-page":"473","article-title":"Hepatic encephalopathy in patients with cirrhosis and upper GI bleeding","volume":"47","author":"Tromn A","year":"2000","journal-title":"Hepatology"},{"key":"e_1_2_5_20_1","first-page":"69","article-title":"Hepatic encephalopathy in Saudi Arabia. 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