Epistaxis in end stage liver disease masquerading as severe upper gastrointestinal hemorrhage

Table 1 Characteristics of patients n (%)

Characteristic	Data
Age (yr, mean ± SD, range)	54.4 ± 9.7 (40-75)
Sex (Male/Female)	12/8 (60/40)
Child Pugh class	A: 0; B: 1 (5); C: 19 (95)
MELD score, (mean ± SD, range)	29.6 ± 7.5
Etiology
HCV + Alcoholic	5 (25)
Alcoholic	5 (25)
Cryptogenetic	5 (25)
HCV	4 (20)
PBC + AIH	1 (5)
Inpatient start of bleeding	18 (90)
Nasogastric tube placed prior to bleeding	16 (80)
Hematemesis	15 (75)
Melena and/or Hematochezia	9 (45)
PT (s, mean ± SD, range)	20.7 ± 6.8 (13.4-42.6)
INR (mean ± SD, range)	2.3 ± 1.4 (1.4-7.8)
Platelet count (/mm3, mean ± SD, range)	51000 ± 32082 (11000-120000)
Hematocrit (mean ± SD, range)	23.5% ± 2.9% (18.5%-29.9%)

AIH: Autoimmune hepatitis; HCV: Hepatitis C virus; INR: International normalized ratio; MELD: Model for end stage liver disease; PBC: Primary biliary cirrhosis; PT: Prothrombin time; SD: Standard deviation.

Table 2 Outcomes of patients n (%)

	No. of patients	Age (yr)	PT (s)	INR	Platelet count (/mm3)	MELD score	Time between diagnosis and death, OLT or discharge (d)	Rebleeding before death, OLT or discharge
OLT	12 (60)	51.5 ± 8.7	22.6 ± 7.9	2.7 ± 1.7	43333 ± 27955	31.8 ± 6.4	8.4 ± 8.2	3 (25)
Death in hospital	5 (25)	57.6 ± 10.1	17.7 ± 5.5	1.8 ± 0.5	54400 ± 41578	30.8 ± 9.5	10.8 ± 6.0	1 (20)
Discharge without OLT	3 (15)	60.3 ± 11.7	18.6 ± 0.7	1.8 ± 0.1	76000 ± 26514	20.5 ± 2.1	39.0 ± 39.9	1 (33)

MELD: Model for end stage liver disease; OLT: Orthotopic liver transplantation; PT: Prothrombin time; INR: International normalized ratio; SD: Standard deviation.