Predictive Factors and Treatment Outcomes in Patients with Acute Variceal Bleeding

Background/Objectives: The study aimed to determine the demographic and clinical characteristics of patients with acute variceal bleeding and identify predictive factors associated with treatment outcomes. Methods: The retrospective study included 91 adults hospitalised for oesophageal and/or gastric variceal bleeding at the Department of Gastroenterology, University Hospital of Split. Data were collected on patients’ demographics, clinical characteristics and laboratory findings, as well as treatment outcomes, including length of hospital stay, need for repeat endoscopy, rebleeding, infection incidence, and six-week mortality. Results: Of the 91 patients included, 85.7% were male, and the mean age was 61 ± 9 years. Liver cirrhosis was present in 94.5% of patients, with alcoholic aetiology in 76.7% of cases. The median MELD-Na score was 15 (IQR 11–21), and more than 40% of patients were classified as Child–Pugh B. The median length of hospital stay was 8 days (IQR 5–10.5). Diagnostic EGD was performed in 94.5% of patients, with 80.2% undergoing the procedure within 12 h of admission. Vasoactive therapy was administered to 65.9% of patients, while antibiotic prophylaxis was given in 82.4%. In-hospital mortality was 16.5%, and the cumulative six-week mortality was 25.3%. The severity of liver disease (expressed by MELD-Na and Child–Pugh scores) was associated with a higher risk of in-hospital mortality (p = 0.0045 and p = 0.009, respectively). Early endoscopic intervention did not result in a statistically significant reduction in in-hospital mortality (8.7% vs. 23.5%; p = 0.104). The use of antibiotic prophylaxis, vasoactive drugs, and endoscopic ligation was not associated with lower rates of infections, repeated endoscopies, or mortality. Conclusions: There was a positive correlation between the severity of decompensated liver cirrhosis and in-hospital mortality. Early endoscopic intervention (within 12 h of admission) was not statistically significant in reducing mortality. The use of antibiotic prophylaxis was not associated with reduced mortality or lower incidence of infections. Vasoactive therapy did not significantly reduce the need for repeat endoscopic intervention. Endoscopic ligation did not decrease the likelihood of rebleeding during hospitalisation, in-hospital mortality, or the length of hospital stay.