Abstract
Background Acute upper gastrointestinal (GIT) bleeding is a common medical emergency
clinically manifested by hematemesis and/or melena. This study aimed to elucidate
the roles of Helicobacter pylori and the platelet-spleen ratio as risk factors for variceal bleeding in patients with
portal hypertension secondary to liver cirrhosis.
Methods The study was conducted on 200 patients with liver cirrhosis of various etiologies
who were divided into two groups: group 1 included 100 patients with liver cirrhosis
and portal hypertension with or without a history of upper GIT bleeding, and group
2 included 100 patients with liver cirrhosis without portal hypertension. Upper GIT
endoscopy was performed, and biopsy samples were taken from the gastric antral mucosa
for rapid urease testing. The platelet-spleen diameter ratio was calculated for all
patients.
Results In group 1, most patients who had a history of variceal bleeding were H. pylori-negative whereas most patients without a history of variceal bleeding were H. pylori-positive, implying that H. pylori may play a significant role as a protective factor against variceal bleeding. The
calculated odds ratio for the rapid urease test was low (0.851), whereas the calculated
odds ratio for the platelet-spleen diameter ratio was higher (9.766) than that for
the rapid urease test. Thus, the rapid urease test plays a significantly higher role
than the platelet-spleen ratio as a risk factor for bleeding (p-value = 0.001).
Conclusions H. pylori has a more significant relationship with upper GIT bleeding than the platelet-spleen
diameter ratio.
Keywords
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Article info
Publication history
Published online: January 02, 2022
Accepted:
October 16,
2021
Received:
June 3,
2020
Identification
Copyright
© 2022 Published by Elsevier Inc. on behalf of Southern Society for Clinical Investigation.
