Blood platelet function abnormalities in cirrhotic patients with esophageal varices in relation to the variceal bleeding history*

SummaryBlood platelet function was evaluated in 10 men, all 50 years old, with untreated, mild hypertension. Each patient was examined four times: At the beginning of the study, after 5 weeks on placebo treatment, after the following 5 weeks on propranolol 160 mg daily, and finally after a second period of 5 weeks on placebo. At baseline the plasma level of the platelet release product (β-thromboglobulin (BTG) was 41.6 (30.5-57.0) μg/l (median and 95% confidence interval). During the first placebo period BTG was normalized to 21.0 (14.1-25.9) μg/l. While systolic blood pressure and heart rate fell during β-adrenergic receptor blockade, BTG remained unchanged throughout the rest of the observation periods. Platelet size increased significantly during treatment with β-blocker. The present study indicates that the normalization of elevated platelet function which previously has been reported to occur during anti-hypertensive drug therapy, may be explained by patient adaptation to the blood sampling procedure.

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

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2019.1.6 ◽

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

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Faculty Opinions recommendation of Carvedilol for primary prophylaxis of variceal bleeding in cirrhotic patients with haemodynamic non-response to propranolol.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718158968.793499801 ◽

2014 ◽

Author(s):

Tilman Sauerbruch

Keyword(s):

Variceal Bleeding ◽

Primary Prophylaxis ◽

Cirrhotic Patients

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The effect of bacterial infections in cirrhotic patients with esophageal variceal bleeding

Annals of Hepatology ◽

10.1016/s1665-2681(19)30866-x ◽

2014 ◽

Vol 13 (3) ◽

pp. 364-369 ◽

Cited By ~ 3

Author(s):

Zuo-Hua Gan ◽

Chen-Chi Tsai ◽

Kuo-Chih Tseng ◽

Chih-Chun Tsai ◽

Yu-Hsi Hsieh ◽

...

Keyword(s):

Variceal Bleeding ◽

Bacterial Infections ◽

Esophageal Variceal ◽

Esophageal Variceal Bleeding ◽

Cirrhotic Patients

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Diagnostic value of spleen stiffness by magnetic resonance elastography for prediction of esophageal varices in cirrhotic patients

Abdominal Radiology ◽

10.1007/s00261-020-02628-x ◽

2020 ◽

Author(s):

Zih-En Jhang ◽

Kuan-Lin Wu ◽

Chia-Bang Chen ◽

Yao-Li Chen ◽

Ping-Yi Lin ◽

...

Keyword(s):

Magnetic Resonance ◽

Esophageal Varices ◽

Diagnostic Value ◽

Magnetic Resonance Elastography ◽

Spleen Stiffness ◽

Cirrhotic Patients

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

Egyptian Liver Journal ◽

10.1186/s43066-021-00088-6 ◽

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.

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