Comparison of clinical outcomes in cirrhotic patients presenting with acute variceal and non-variceal gastrointestinal bleeding

In patients with advanced chronic liver disease, acute gastrointestinal bleeding can present as acute variceal bleeding (AVB) or non-variceal bleeding (NVB). This study aimed to compare clinical outcomes between AVB and NVB, and identify predictors of liver-related death following AVB. A retrospective, observational, single-center study including patients with acute GI bleeding from 2016 to 2022, divided into AVB and NVB groups. Outcomes included complications, rebleeding, further decompensation, and liver-related death. Survival was analyzed using Kaplan-Meier, and predictors were identified with Cox regression and ROC curves. A total of 154 patients were included. The NVB group (n = 57) was older (67 vs. 55 years, p  < 0.001), had higher MELDNa scores (18 vs. 15, p  = 0.016), and more ascites at admission (52.6% vs. 35.1%, p  = 0.033). There were no significant differences between groups in in-hospital mortality, complications, rebleeding, further decompensation, or liver-related death during follow-up. In AVB patients, MELDNa independently predicted liver-related death at 30 and 90 days ( p  < 0.001). AVB, whether a first or subsequent decompensation event, showed similar 30-day readmission rates and liver-related death. Clinical outcomes were similar between AVB and NVB. In AVB patients, MELDNa was an independent predictor of short-term liver-related mortality.