Survival after first diagnosis of oesophageal or gastric varices in a single centre in northern Sweden: a retrospective study

Aim of the study
Oesophageal and gastric varices are well-known causes of morbidity and mortality in patients with liver cirrhosis. The aim of this retrospective observational study was to analyse clinical characteristics and outcomes for patients with oesophageal and gastric varices at Norrland’s University Hospital, Umeå, Sweden.

Material and methods
Data from medical records were collected retrospectively from 246 patients with oesophageal and gastric varices between 2006 and 2019.

Results
At the end of the study 60.1% of the patients had died at a median age of 69 years (range 26-95). Mortality of patients with gastro-oesophageal varices was significantly greater than that of the general population. Median survival from the time of variceal diagnosis was 59 months (confidence interval [CI] 95%: 45-73 months). Five-year and 10-year cumulative survival rates in the entire cohort were 49.7% and 27.7%, respectively, with no sex-related differences. The highest mortality rate was seen in alcoholic cirrhosis with concomitant hepatitis. Mortality was higher in Child-Turcotte-Pugh (CTP) B and C compared to CTP A. Liver failure and liver cancer were the most common causes of death (43.8%). Thirty-one percent of the patients had a variceal haemorrhage. Eleven percent were subjected to liver transplantation, whereas 3.9% of the patients had been submitted to a transjugular intrahepatic portosystemic shunt (TIPS) procedure.

Conclusions
Despite the latest therapeutic advances, the survival of patients with gastro-oesophageal varices remains significantly reduced. All-cause mortality was significantly related to CTP class, aetiology, occurrence of variceal bleeding, whether variceal bleeding was the primary symptom and whether patients had undergone liver transplantation or not.