scholarly journals Endoscopic variceal ligation performs better than injection sclerotherapy in decompensated cirrhotic patients with acute variceal bleeding: a real world comparative cohort analysis

HPB ◽  
2020 ◽  
Vol 22 ◽  
pp. S258
Author(s):  
M. Bernon ◽  
U. Kotze ◽  
C. Kloppers ◽  
S. Burmeister ◽  
G. Chinnery ◽  
...  
Keyword(s):  
Real World ◽  
Variceal Bleeding ◽  
Cohort Analysis ◽  
Injection Sclerotherapy ◽  
Endoscopic Variceal Ligation ◽  
Acute Variceal Bleeding ◽  
Cirrhotic Patients ◽  
Better Than

scholarly journals The Presence of Ascites Affects the Predictive Value of HVPG on Early Rebleeding in Patients with Cirrhosis

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Chuan Liu ◽  
Ruoyang Shao ◽  
Sining Wang ◽  
Guangchuan Wang ◽  
Lifen Wang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Variceal Bleeding ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Venous Pressure ◽  
Predictive Performance ◽  
Bleeding Risk ◽  
Endoscopic Variceal Ligation ◽  
Acute Variceal Bleeding ◽  
Cirrhotic Patients

Background and Aims. Gastroesophageal variceal bleeding is a serious complication of portal hypertension in cirrhotic patients and could be predicted by hepatic venous pressure gradient (HVPG). However, whether the presence of ascites affects the prognostic value of HVPG for patients with acute variceal bleeding is still unknown. This retrospective study is aimed at investigating the influence of ascites on predictive performance of HVPG for early rebleeding in cirrhotic patients with acute variceal bleeding. Methods. In this retrospective study, a total of 148 patients with cirrhosis hospitalized for acute variceal bleeding who underwent HVPG measurement and endoscopic variceal ligation (EVL) for the prevention of rebleeding were included. The receiver operating characteristic curve (ROC) and logistical regression method were employed to analyze the predictive performance of HVPG for early rebleeding. The locally weighted scatterplot smoothing approach was adopted to assess the monotonicity between bleeding risk and HVPG. Results. A significantly higher HVPG level was observed in patients with early rebleeding compared to patients without rebleeding in the nonascites cohort. When using HVPG to predict early rebleeding, there was a lower area under curve in the ascites cohort compared to the nonascites cohort. HVPG was recognized as a risk factor for early rebleeding by a logistic regression model only in the nonascites cohort. An overall monotonicity in the trend of change in HVPG and risk for early rebleeding was observed in the nonascites cohort solely. Conclusion. The predictive value of HVPG for early rebleeding in patients with cirrhosis that developed acute variceal bleeding is hindered by the presence of ascites.

Efficacy of endoscopic variceal ligation and sclerotheraphy in treatment of acute variceal bleeding

2007 ◽  
Vol 45 (05) ◽  
Author(s):  
C Rédei ◽  
M Szőnyi ◽  
A Zaja ◽  
L Tóth ◽  
Á Svejkovszky ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Endoscopic Variceal Ligation ◽  
Acute Variceal Bleeding

PROGNOSTIC VALUE OF COMBINATION AIMS65 AND MELD SCORES IN CIRRHOTIC PATIENTS WITH ACUTE VARICEAL BLEEDING

2019 ◽  
pp. 35-40
Author(s):  
Thi Nhung Nguyen ◽  
Trung Nam Phan ◽  
Van Huy Tran
Keyword(s):  
Clinical Practice ◽  
Portal Hypertension ◽  
Key Words ◽  
Variceal Bleeding ◽  
Prognostic Value ◽  
High Rate ◽  
Central Hospital ◽  
Acute Variceal Bleeding ◽  
Cirrhotic Patients ◽  
Sensitivity Specificity

Bacground: Variceal bleeding is a severe complication of portal hypertension due to cirrhosis with high rate of motality, hence, predicting early rebleeding and mortality in cirrhotic patients with acute variceal bleeding is vital in clinical practice. Objectives: To evaluate the prognostic value of the combination of AIMS65 and MELD scores in predicting first 5 days in-hospital rebleeding and mortality in cirrhotic patients with acute variceal bleeding. Materials and Methods: 44 cirrhotic patients with acute variceal bleeding hospitalized at Hue Central Hospital. MELD and AIMS65 scores were calculated within the first 24 hours and monitoring rebleeding and mortality in the first 5 days in these patients. Results: AIMS65, MELD scores can predict first 5 days rebleeding and mortality with AUROC are 0.81, 0.69 and 0.92, 0.95, respectively. Combination of AIMS65 and MELD scores can predict first 5 days in hospital rebleeding with AUROC is 0.84, sensitivity 83.3%, specificity 81.6% (p<0.001) and mortality with AUROC is 0.96, sensitivity 100%, specificity 92.7% (p<0.001). Conclusions: The combination of AIMS65 and MELD scores increased the sensitivity, specificity and prognostic value in predicting first 5 days in-hospital rebleeding and mortality in cirrhotic patients with acute variceal bleeding in compare to each single scores. Key words: AiMS65 score, MELd, acute variceal bleeding

scholarly journals Performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rehab Elsayed Elsafty ◽  
Abdallah Ahmed Elsawy ◽  
Ahmed Fawzy Selim ◽  
Atef Mohamed Taha
Keyword(s):  
Hepatic Encephalopathy ◽  
Variceal Bleeding ◽  
Early Discharge ◽  
Meld Score ◽  
Bleeding Control ◽  
Acute Variceal Bleeding ◽  
Prophylactic Measures ◽  
Significant Performance ◽  
Cirrhotic Patients ◽  
Grade 3

Abstract Background Hepatic encephalopathy exacerbates the morbidity, delays hospital discharge, and increases the rate of readmissions of cirrhotic patients, particularly those are admitted by acute variceal bleeding. We evaluated the performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding, in comparison to Child-Pugh and MELD scores. This prospective cohort study was conducted on 250 cirrhotic patients who were consecutively presented by acute variceal bleeding in the period from January to December 2020 at Tanta university emergency hospital. Albumin-bilirubin, Child-Pugh, and MELD scores were measured at admission, and then all patients were followed up for 4 weeks after endoscopic bleeding control for possible occurrence of hepatic encephalopathy Results Albumin-bilirubin, Child-Pugh, and MELD scores had significant performances in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding; in this regard, albumin-bilirubin score had the highest accuracy (AUC 0.858, CI 0.802-0.914, sig 0.000) followed by Child-Pugh score (AUC 0.654, CI 0.574–0.735, sig 0.001) and then MELD score (AUC 0.602, CI 0.519–0.686, sig 0.031). The cumulative incidence of hepatic encephalopathy in cirrhotic patients with albumin-bilirubin grade 3 was found to be significantly more than that present in albumin-bilirubin grade 2; most of these hepatic encephalopathy cases occurred in the first 2 weeks of follow-up period. Conclusions Albumin-bilirubin score has a significant performance in risk prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding better than Child-Pugh and MELD scores. Albumin-bilirubin grades could be used as a risk stratifying tool to triage cirrhotic patients who will benefit from early discharge after bleeding control and those patients who will benefit from prophylactic measures for hepatic encephalopathy.

scholarly journals Short-Term Outcome of Patients with Cirrhosis and Concurrent Portal Cavernoma Presenting with Acute Variceal Bleeding

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Xuefeng Luo ◽  
Wanqin Wang ◽  
Xiaoli Fan ◽  
Ying Zhao ◽  
Xiaoze Wang ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Variceal Bleeding ◽  
Day Treatment ◽  
First Episode ◽  
Control Group ◽  
Short Term ◽  
Term Outcome ◽  
Acute Variceal Bleeding ◽  
Portal Cavernoma ◽  
Cirrhotic Patients

Background and Aim. The outcome of cirrhotic patients with main portal vein occlusion and portal cavernoma after the first episode of acute variceal bleeding (AVB) is unknown. We compared short-term outcomes after AVB in cirrhotic patients with and without portal cavernoma. Methods. Between January 2009 and September 2014, 28 patients with cirrhosis and portal cavernoma presenting with the first occurrence of AVB and 56 age-, sex-, and Child-Pugh score-matched cirrhotic patients without portal cavernoma were included. The primary endpoints were 5-day treatment failure and 6-week mortality. Results. The 5-day treatment failure rate was higher in the cavernoma group than in the control group (32.1% versus 12.5%; p=0.031). The 6-week mortality rate did not differ between the cavernoma and control group (25% versus 12.5%, p=0.137). Multivariable Cox proportional hazard regression analyses revealed that 5-day treatment failure (HR = 1.223, 95% CI = 1.082 to 1.384; p=0.001) independently predicted 6-week mortality. Conclusions. Cirrhotic patients with AVB and portal cavernoma have worse short-term prognosis than patients without portal cavernoma. The 5-day treatment failure was an independent risk factor for 6-week mortality in patients with cirrhosis and portal cavernoma.

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