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Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study

BACKGROUND AND AIMS: Emergency endoscopy is recommended for patients with acute esophageal variceal bleeding (EVB) and their prognosis has improved markedly over past decades due to the increased specialization of endoscopic practice. The study aimed to compare outcomes following emergency endoscopi...

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Autores principales: Huang, Yifei, Zhang, Wenhui, Xiang, Huiling, Liu, Yanna, Yuan, Lili, Zhang, Liyao, Hu, Shengjuan, Xia, Dongli, Li, Jia, Gao, Min, Wang, Xing, Qi, Xingsi, Peng, Lijun, Song, Ying, Zhou, Xiqiao, Zeng, Jing, Tan, Xiaoyan, Deng, Mingming, Fang, Haiming, Qi, Shenglin, He, Song, He, Yongfeng, Ye, Bin, Wu, Wei, Dang, Tong, Shao, Jiangbo, Wei, Wei, Hu, Jianping, Yong, Xin, He, Chaohui, Bao, Jinlun, Zhang, Yuening, Zhang, Guo, Ji, Rui, Bo, Yang, Yan, Wei, Li, Hongjiang, Wang, Yanling, Li, Mengmeng, Wang, Fengmei, Lian, Jia, Liu, Chang’en, Cao, Ping, Liu, Zhenbei, Liu, Aimin, Zhao, Lili, Li, Shuang, Wu, Yunhai, Gu, Ye, Wang, Yan, Fang, Yanfei, Jiang, Pan, Wu, Bin, Liu, Chuan, Qi, Xiaolong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9092278/
https://www.ncbi.nlm.nih.gov/pubmed/35572990
http://dx.doi.org/10.3389/fmed.2022.872881
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author Huang, Yifei
Zhang, Wenhui
Xiang, Huiling
Liu, Yanna
Yuan, Lili
Zhang, Liyao
Hu, Shengjuan
Xia, Dongli
Li, Jia
Gao, Min
Wang, Xing
Qi, Xingsi
Peng, Lijun
Song, Ying
Zhou, Xiqiao
Zeng, Jing
Tan, Xiaoyan
Deng, Mingming
Fang, Haiming
Qi, Shenglin
He, Song
He, Yongfeng
Ye, Bin
Wu, Wei
Dang, Tong
Shao, Jiangbo
Wei, Wei
Hu, Jianping
Yong, Xin
He, Chaohui
Bao, Jinlun
Zhang, Yuening
Zhang, Guo
Ji, Rui
Bo, Yang
Yan, Wei
Li, Hongjiang
Wang, Yanling
Li, Mengmeng
Wang, Fengmei
Lian, Jia
Liu, Chang’en
Cao, Ping
Liu, Zhenbei
Liu, Aimin
Zhao, Lili
Li, Shuang
Wu, Yunhai
Gu, Ye
Wang, Yan
Fang, Yanfei
Jiang, Pan
Wu, Bin
Liu, Chuan
Qi, Xiaolong
author_facet Huang, Yifei
Zhang, Wenhui
Xiang, Huiling
Liu, Yanna
Yuan, Lili
Zhang, Liyao
Hu, Shengjuan
Xia, Dongli
Li, Jia
Gao, Min
Wang, Xing
Qi, Xingsi
Peng, Lijun
Song, Ying
Zhou, Xiqiao
Zeng, Jing
Tan, Xiaoyan
Deng, Mingming
Fang, Haiming
Qi, Shenglin
He, Song
He, Yongfeng
Ye, Bin
Wu, Wei
Dang, Tong
Shao, Jiangbo
Wei, Wei
Hu, Jianping
Yong, Xin
He, Chaohui
Bao, Jinlun
Zhang, Yuening
Zhang, Guo
Ji, Rui
Bo, Yang
Yan, Wei
Li, Hongjiang
Wang, Yanling
Li, Mengmeng
Wang, Fengmei
Lian, Jia
Liu, Chang’en
Cao, Ping
Liu, Zhenbei
Liu, Aimin
Zhao, Lili
Li, Shuang
Wu, Yunhai
Gu, Ye
Wang, Yan
Fang, Yanfei
Jiang, Pan
Wu, Bin
Liu, Chuan
Qi, Xiaolong
author_sort Huang, Yifei
collection PubMed
description BACKGROUND AND AIMS: Emergency endoscopy is recommended for patients with acute esophageal variceal bleeding (EVB) and their prognosis has improved markedly over past decades due to the increased specialization of endoscopic practice. The study aimed to compare outcomes following emergency endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL) in cirrhotic patients with acute EVB. METHODS: Cirrhotic patients with acute EVB who underwent emergency endoscopy were retrospectively enrolled from 2013 to 2020 across 34 university hospitals from 30 cities. The primary outcome was the incidence of 5-day rebleeding after emergency endoscopy. Subgroup analysis was stratified by Child-Pugh class and bleeding history. A 1:1 propensity score matching (PSM) analysis was performed. RESULTS: A total of 1,017 and 382 patients were included in EIS group and EVL group, respectively. The 5-day rebleeding incidence was similar between EIS group and EVL group (4% vs. 5%, P = 0.45). The result remained the same after PSM (P = 1.00). Among Child-Pugh class A, B and C patients, there were no differences in the 5-day rebleeding incidence between the two groups after PSM (P = 0.25, 0.82, and 0.21, respectively). As for the patients with or without bleeding history, the differences between EIS group and EVL group were not significant after PSM (P = 1.00 and 0.26, respectively). CONCLUSION: The nationwide cohort study indicates that EIS and EVL are both efficient emergency endoscopic treatment strategies for acute EVB. EIS should not be dismissed as an economical and effective emergency endoscopic treatment strategy of acute EVB. ClincialTrials.gov number NCT04307264.
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spelling pubmed-90922782022-05-12 Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study Huang, Yifei Zhang, Wenhui Xiang, Huiling Liu, Yanna Yuan, Lili Zhang, Liyao Hu, Shengjuan Xia, Dongli Li, Jia Gao, Min Wang, Xing Qi, Xingsi Peng, Lijun Song, Ying Zhou, Xiqiao Zeng, Jing Tan, Xiaoyan Deng, Mingming Fang, Haiming Qi, Shenglin He, Song He, Yongfeng Ye, Bin Wu, Wei Dang, Tong Shao, Jiangbo Wei, Wei Hu, Jianping Yong, Xin He, Chaohui Bao, Jinlun Zhang, Yuening Zhang, Guo Ji, Rui Bo, Yang Yan, Wei Li, Hongjiang Wang, Yanling Li, Mengmeng Wang, Fengmei Lian, Jia Liu, Chang’en Cao, Ping Liu, Zhenbei Liu, Aimin Zhao, Lili Li, Shuang Wu, Yunhai Gu, Ye Wang, Yan Fang, Yanfei Jiang, Pan Wu, Bin Liu, Chuan Qi, Xiaolong Front Med (Lausanne) Medicine BACKGROUND AND AIMS: Emergency endoscopy is recommended for patients with acute esophageal variceal bleeding (EVB) and their prognosis has improved markedly over past decades due to the increased specialization of endoscopic practice. The study aimed to compare outcomes following emergency endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL) in cirrhotic patients with acute EVB. METHODS: Cirrhotic patients with acute EVB who underwent emergency endoscopy were retrospectively enrolled from 2013 to 2020 across 34 university hospitals from 30 cities. The primary outcome was the incidence of 5-day rebleeding after emergency endoscopy. Subgroup analysis was stratified by Child-Pugh class and bleeding history. A 1:1 propensity score matching (PSM) analysis was performed. RESULTS: A total of 1,017 and 382 patients were included in EIS group and EVL group, respectively. The 5-day rebleeding incidence was similar between EIS group and EVL group (4% vs. 5%, P = 0.45). The result remained the same after PSM (P = 1.00). Among Child-Pugh class A, B and C patients, there were no differences in the 5-day rebleeding incidence between the two groups after PSM (P = 0.25, 0.82, and 0.21, respectively). As for the patients with or without bleeding history, the differences between EIS group and EVL group were not significant after PSM (P = 1.00 and 0.26, respectively). CONCLUSION: The nationwide cohort study indicates that EIS and EVL are both efficient emergency endoscopic treatment strategies for acute EVB. EIS should not be dismissed as an economical and effective emergency endoscopic treatment strategy of acute EVB. ClincialTrials.gov number NCT04307264. Frontiers Media S.A. 2022-04-27 /pmc/articles/PMC9092278/ /pubmed/35572990 http://dx.doi.org/10.3389/fmed.2022.872881 Text en Copyright © 2022 Huang, Zhang, Xiang, Liu, Yuan, Zhang, Hu, Xia, Li, Gao, Wang, Qi, Peng, Song, Zhou, Zeng, Tan, Deng, Fang, Qi, He, He, Ye, Wu, Dang, Shao, Wei, Hu, Yong, He, Bao, Zhang, Zhang, Ji, Bo, Yan, Li, Wang, Li, Wang, Lian, Liu, Cao, Liu, Liu, Zhao, Li, Wu, Gu, Wang, Fang, Jiang, Wu, Liu and Qi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Huang, Yifei
Zhang, Wenhui
Xiang, Huiling
Liu, Yanna
Yuan, Lili
Zhang, Liyao
Hu, Shengjuan
Xia, Dongli
Li, Jia
Gao, Min
Wang, Xing
Qi, Xingsi
Peng, Lijun
Song, Ying
Zhou, Xiqiao
Zeng, Jing
Tan, Xiaoyan
Deng, Mingming
Fang, Haiming
Qi, Shenglin
He, Song
He, Yongfeng
Ye, Bin
Wu, Wei
Dang, Tong
Shao, Jiangbo
Wei, Wei
Hu, Jianping
Yong, Xin
He, Chaohui
Bao, Jinlun
Zhang, Yuening
Zhang, Guo
Ji, Rui
Bo, Yang
Yan, Wei
Li, Hongjiang
Wang, Yanling
Li, Mengmeng
Wang, Fengmei
Lian, Jia
Liu, Chang’en
Cao, Ping
Liu, Zhenbei
Liu, Aimin
Zhao, Lili
Li, Shuang
Wu, Yunhai
Gu, Ye
Wang, Yan
Fang, Yanfei
Jiang, Pan
Wu, Bin
Liu, Chuan
Qi, Xiaolong
Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study
title Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study
title_full Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study
title_fullStr Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study
title_full_unstemmed Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study
title_short Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study
title_sort treatment strategies in emergency endoscopy for acute esophageal variceal bleeding (chess1905): a nationwide cohort study
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9092278/
https://www.ncbi.nlm.nih.gov/pubmed/35572990
http://dx.doi.org/10.3389/fmed.2022.872881
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