Timing of endoscopy in patients with cirrhosis and acute variceal bleeding: a single-center retrospective study

BMC Gastroenterology

Research

Cyriac Abby Philips¹  Xiaodong Shao²  Xiaozhong Guo²  Deli Zou²  Chunmei Wang²  Shixue Xu²  Mengyuan Peng³  Xingshun Qi⁴  Zhaohui Bai⁵  Metin Başaranoğlu⁶ 

[1] Clinical and Translational Hepatology & Monarch Liver Laboratory, The Liver Institute, Center of Excellence in Gastrointestinal Sciences, Rajagiri Hospital, Aluva, Kerala, India;Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, 110840, Shenyang, Liaoning Province, China;Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, 110840, Shenyang, Liaoning Province, China;Postgraduate College, Jinzhou Medical University, Jinzhou, P.R. China;Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, 110840, Shenyang, Liaoning Province, China;Postgraduate College, Jinzhou Medical University, Jinzhou, P.R. China;Postgraduate College, Shenyang Pharmaceutical University, Shenyang, P.R. China;Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, 110840, Shenyang, Liaoning Province, China;Postgraduate College, Shenyang Pharmaceutical University, Shenyang, P.R. China;Department of Internal Medicine, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey;

关键词: Acute variceal bleeding;    Liver cirrhosis;    Endoscopy;    Five-day failure to control bleeding;    In-hospital mortality;   

DOI  :  10.1186/s12876-023-02766-8

 received in 2022-07-25, accepted in 2023-04-15,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe optimal timing of endoscopy in liver cirrhosis with acute variceal bleeding (AVB) remains controversial in current guidelines and studies.MethodsConsecutive patients with liver cirrhosis and AVB were screened. The timing of endoscopy was calculated from the last presentation of AVB or the admission to endoscopy. Early endoscopy was defined as the interval < 12 h, < 24 h, or < 48 h. A 1:1 propensity score matching (PSM) analysis was performed. Five-day failure to control bleeding and in-hospital mortality were evaluated.ResultsOverall, 534 patients were included. When the timing of endoscopy was calculated from the last presentation of AVB, PSM analysis demonstrated that the rate of 5-day failure to control bleeding was significantly higher in early endoscopy group defined as < 48 h (9.7% versus 2.4%, P = 0.009), but not < 12 h (8.7% versus 6.5%, P = 1.000) or < 24 h (13.4% versus 6.2%, P = 0.091), and that the in-hospital mortality was not significantly different between early and delayed endoscopy groups (< 12 h: 6.5% versus 4.3%, P = 1.000; <24 h: 4.1% versus 3.1%, P = 1.000; <48 h: 3.0% versus 2.4%, P = 1.000). When the timing of endoscopy was calculated from the admission, PSM analyses did not demonstrate any significant difference in the rate of 5-day failure to control bleeding (< 12 h: 4.8% versus 12.7%, P = 0.205; <24 h: 5.2% versus 7.7%, P = 0.355; <48 h: 4.5% versus 6.0%, P = 0.501) or in-hospital mortality (< 12 h: 4.8% versus 4.8%, P = 1.000; <24 h: 3.9% versus 2.6%, P = 0.750; <48 h: 2.0% versus 2.5%, P = 1.000) between early and delayed endoscopy groups.ConclusionOur study could not support any significant association of timing of endoscopy with cirrhotic patients with AVB.

【 授权许可】

CC BY   
© The Author(s) 2023

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