Assessment of Clinical Profile and Outcome of Upper Gastrointestinal Bleed in Patients with Liver Cirrhosis: A Prospective Study in a Tertiary Care Hospital in Northeast India

Background: Upper gastrointestinal (GI) bleeding is a common and life-threatening complication in patients with liver cirrhosis. It is primarily caused by variceal bleeding due to portal hypertension or non-variceal causes such as gastroduodenal ulcers. Despite advancements in diagnostic and therapeutic strategies, upper GI bleeding remains a major contributor to morbidity and mortality in cirrhotic patients, necessitating comprehensive evaluation and management. Aim: To assess the clinical profile and outcomes of upper GI bleeding in patients with liver cirrhosis and identify the variceal and non-variceal etiologies to guide effective management strategies. Methods: This prospective observational study was conducted at the Department of Gastroenterology, Gauhati Medical College and Hospital, from March 2023 to April 2024. A total of 128 cirrhotic patients presenting with upper GI bleeding were included. Data on clinical features, endoscopic findings, treatment outcomes, and in-hospital mortality were collected and analyzed. Statistical analysis was performed using SPSS version 23.0. Results: Among the 128 patients, 92 (71.9%) had variceal bleeding, predominantly esophageal varices, while 36 (28.1%) had non-variceal bleeding, mainly gastroduodenal ulcers. Anemia was the most common complication (87.5%), followed by renal failure (43.7%). The in-hospital mortality rate was 12.5%, primarily in patients with severe variceal bleeding. Alcoholism was the leading cause of cirrhosis (49.3%), followed by MASH (21.9%). Endoscopic variceal ligation (EVL) was the primary intervention in variceal cases, while ulcers were managed with standard endoscopic therapies. Conclusion: Upper GI bleeding in cirrhotic patients is a critical condition with significant morbidity and mortality. Variceal bleeding remains the predominant cause, often associated with poor outcomes. Early diagnosis, prompt intervention, and targeted management strategies are essential to improve survival and reduce complications. Recommendations: Efforts should focus on preventive strategies, including early screening for high-risk varices and lifestyle modifications to reduce alcohol-induced liver damage. A multidisciplinary approach and adherence to evidence-based protocols are crucial for optimizing patient outcomes.