Burden and determinants of upper gastrointestinal bleeding in cirrhotic patients: evidence from Sub-Saharan Africa, 2024.

Abstract

Introduction: Upper gastrointestinal bleeding (UGIB) is a serious and life-threatening complication of liver cirrhosis, contributing a notable percentage to emergency admissions, morbidity, and mortality. There is limited evidence regarding UGIB prevalence and determinants among cirrhotic patients in Ethiopia, particularly in the study setting.

Objective: To determine the magnitude of UGIB and its associated factors in cirrhotic patients visiting public hospitals in Northwest Ethiopia, 2024.

Methods: A facility-based cross-sectional study was performed in 256 cirrhotic patients from November 2024 to January 2025. Participants were enrolled through consecutive sampling. Data were gathered with the help of a structured checklist, entered into Epi Data version 3.1, and analyzed using SPSS version 27.0. Descriptive statistics presented patient characteristics. Bivariate and multivariate logistic regression analyses were performed to determine factors related to UGIB. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were presented, and the statistical significance level was p < 0.05.

Results: UGIB prevalence was 46.1%. Significantly associated factors were illness duration > 24 months (AOR = 2.42; 95% CI: 1.34-4.35), platelet count 50,000-100,000/µL (AOR = 1.90; 95% CI: 1.23-3.61), platelet count < 50,000/µL (AOR = 5.27; 95% CI: 2.63-10.56), and absence of prior endoscopy (AOR = 3.62; 95% CI: 1.95-6.69).

Conclusion: UGIB prevalence was high in this cirrhotic population, primarily due to esophageal varices. Long duration of the disease, thrombocytopenia, and absence of endoscopic screening were significant risk factors identified. These findings underscore the importance of early endoscopic screening, thrombocytopenia monitoring, and the expansion of preventive services to reduce UGIB-related complications in cirrhotic patients.