Sa1597 The Development and Validation of a Novel Serological Index to Predict Cirrhosis

hospitalization and ED visits.Methods: This retrospective chart review from a safety-net hospital identified all EVLs for primary or secondary prophylaxis of variceal bleeding over a two-year from the hospital database using CPT code for EVL.The control group consists of patients compliant with endoscopy follow-up recommendations after index EVL with documentation of eradication or small varices.The case group consists of patients noncompliant with recommendations or for whom no documentation of variceal eradication is available.The primary outcome is the variceal bleeding rate between the case and control groups.Secondary outcomes include hospitalization and ED visits <30 days of endoscopy.MELD score was collected as a marker of severity of disease.Results: 118 patients had index EVLs during specified time period, 59 for primary and 59 for secondary prophylaxis.62.7% of patients achieved eradication.The median MELD scores were 14.13 +/-5.33 for control group and 17.26 +/-8.07 for case group (p=0.013).Upper GI bleed (UGIB) <30 days of EVL occurred in 3/74 of control patients (4.1%) and 3/43 of case patients (7.0%) and was not significant (p=0.67).The etiology of early bleeding was related to post-banding ulceration in 66.7% of control patients and 33.3% of case patients.UGIB >30 days of any EVL occurred in 19/74 of control patients (25.7%) and 4/43 of case patients (9.3%) and trended towards significance (p=0.05).The etiology of late bleeding was related to variceal bleeding in 52.6% of control patients and 75.0% of case patients.There was no significant difference in hospitalizations or ED visits <30 days of EVL (N=10vs7, p=0.79;N=15vs10, p=0.82 respectively).Conclusions: The rates of esophageal variceal bleeding was not different between patients who were able to achieve variceal eradication to those who were not despite the barriers to compliance at a safety-net hospital.One limitation is that not all bleeding events may have been captured.Interestingly, there was a trend to a higher number of late bleeding events in the group able to achieve eradication bringing into question the utility of achieving eradication.