Abstract: Objective The aim of this study was to investigate the risk factors of re-bleeding after endoscopic esophageal varix ligation (EVL) in the treatment of patients with hepatitis B liver cirrhosis (LC) and esophagogastric varices (EV) bleeding (EVB). Methods 122 patients with LC complicated by EVB were encountered in our hospital between March 2018 and March 2021, and they were all treated with EVL. All patients were followed-up for 1 year. The risk factors was analyzed by multivariate Logistic regression, a predictive model for re-bleeding was established and its predictive efficacy was evaluated by the area under the receiver operating characteristic curve (AUROC). Results At the end of one-year follow-up, the re-bleeding rate in the 122 patients was 27.0%; the incidences of ascites, hepatic encephalopathy (HE), spontaneous bacterial peritonitis (SBP), severe EV in patients with re-bleeding were 36.4%, 12.1%, 15.2% and 75.8%, all significantly higher than 16.9%, 2.2%, 4.5% and 48.3%, P<0.05), while the portal vein diameter was (1.5±0.2)cm, much wider than [(1.1±0.2)cm, P<0.05] in patients without re-bleeding; the multivariate Logistic analysis showed that the ascites [OR(95%CI)=1.818(1.193-2.772)], portal vain diameter [OR(95%CI)=2.085(1.207-3.603)], HE [OR(95%CI)=2.264(1.252-4.092)], severe EV[OR(95%CI)=1.863(1.294-2.682)] and SBP [OR(95%CI)=1.784(1.173-2.714)] were the impacting risk factors for re-bleeding (P<0.05); the formula, e.g., P=1/[1+e^{(0.538Xascites+0.735Xportal vain+0.817XHE+0.622XEV+0.579XSBP-1.053)}] was established based on the Logistic analysis, which had a very good R-squared with the observed data by Hosmer-Lemeshow test(x²=8.361, P=0.399); the ROC analysis showed that the AUC was 0.899, 95%CI:0.832-0.967, with the sensitivity of 87.9%, and the specificity of 86.5%, when the formula we established was applied to predict re-bleeding. Conclusion The patients with LC and EVB having complications and severe EV might have a high risk of re-bleeding after EVL, which should be intervened appropriately clinically with endoscopic measures and/or medicines.

Key words: Liver cirrhosis, Esophagogastric varices bleeding, Endoscopic esophageal varix ligation, Re-bleeding, Risk factors