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Analysis of the timing of endoscopic treatment for esophagogastric variceal bleeding in cirrhosis
BACKGROUND: Existing guidelines recommend endoscopic treatment within 12 h or 12–24 h for patients with esophagogastric variceal bleeding (EGVB) in cirrhosis. In addition, research findings on the optimal time for endoscopy are inconsistent. AIM: The aim of this study was to investigate the relation...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9754091/ https://www.ncbi.nlm.nih.gov/pubmed/36530902 http://dx.doi.org/10.3389/fmed.2022.1036491 |
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author | Wu, Kaini Fu, Yunfeng Guo, Zixiang Zhou, Xiaodong |
author_facet | Wu, Kaini Fu, Yunfeng Guo, Zixiang Zhou, Xiaodong |
author_sort | Wu, Kaini |
collection | PubMed |
description | BACKGROUND: Existing guidelines recommend endoscopic treatment within 12 h or 12–24 h for patients with esophagogastric variceal bleeding (EGVB) in cirrhosis. In addition, research findings on the optimal time for endoscopy are inconsistent. AIM: The aim of this study was to investigate the relationship between the timing of endoscopy and clinical outcomes in cirrhotic patients with EGVB and to analyze the risk factors for the composite outcomes after endoscopic treatment. METHODS: From January 2019 to June 2020, 456 patients with cirrhotic EGVB who underwent endoscopy were matched by a 1:1 propensity score. Finally, 266 patients were divided into two groups, including 133 patients within 12 h (urgent endoscopy group) of admission and after 12 h (non-urgent endoscopy group). Baseline data and clinical outcomes were compared. Logistic regression model analysis was used to determine risk factors for 30 days rebleeding and mortality. RESULTS: In 266 patients, the overall 30 days rebleeding rate and mortality were 10.9% (n = 29) and 3.4% (n = 9), respectively. Patients who underwent endoscopic treatment within 12 h had significantly higher 30 days rebleeding outcomes than those who underwent treatment beyond 12 h (15 vs. 6.8%, p = 0.003). However, 30 days mortality did not differ significantly between the two groups (3 vs. 3.8%, p = 0.736). Logistic regression analysis showed that age and shock on admission were independent risk factors for the composite outcome of 30 days rebleeding and mortality in patients with EGVB. CONCLUSION: The 30 days rebleeding rate in patients with cirrhotic EGVB treated with urgent endoscopy was significantly higher than that in patients treated with non-urgent endoscopy, but there was no significant difference in 30 days mortality. |
format | Online Article Text |
id | pubmed-9754091 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97540912022-12-16 Analysis of the timing of endoscopic treatment for esophagogastric variceal bleeding in cirrhosis Wu, Kaini Fu, Yunfeng Guo, Zixiang Zhou, Xiaodong Front Med (Lausanne) Medicine BACKGROUND: Existing guidelines recommend endoscopic treatment within 12 h or 12–24 h for patients with esophagogastric variceal bleeding (EGVB) in cirrhosis. In addition, research findings on the optimal time for endoscopy are inconsistent. AIM: The aim of this study was to investigate the relationship between the timing of endoscopy and clinical outcomes in cirrhotic patients with EGVB and to analyze the risk factors for the composite outcomes after endoscopic treatment. METHODS: From January 2019 to June 2020, 456 patients with cirrhotic EGVB who underwent endoscopy were matched by a 1:1 propensity score. Finally, 266 patients were divided into two groups, including 133 patients within 12 h (urgent endoscopy group) of admission and after 12 h (non-urgent endoscopy group). Baseline data and clinical outcomes were compared. Logistic regression model analysis was used to determine risk factors for 30 days rebleeding and mortality. RESULTS: In 266 patients, the overall 30 days rebleeding rate and mortality were 10.9% (n = 29) and 3.4% (n = 9), respectively. Patients who underwent endoscopic treatment within 12 h had significantly higher 30 days rebleeding outcomes than those who underwent treatment beyond 12 h (15 vs. 6.8%, p = 0.003). However, 30 days mortality did not differ significantly between the two groups (3 vs. 3.8%, p = 0.736). Logistic regression analysis showed that age and shock on admission were independent risk factors for the composite outcome of 30 days rebleeding and mortality in patients with EGVB. CONCLUSION: The 30 days rebleeding rate in patients with cirrhotic EGVB treated with urgent endoscopy was significantly higher than that in patients treated with non-urgent endoscopy, but there was no significant difference in 30 days mortality. Frontiers Media S.A. 2022-12-01 /pmc/articles/PMC9754091/ /pubmed/36530902 http://dx.doi.org/10.3389/fmed.2022.1036491 Text en Copyright © 2022 Wu, Fu, Guo and Zhou. 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 Wu, Kaini Fu, Yunfeng Guo, Zixiang Zhou, Xiaodong Analysis of the timing of endoscopic treatment for esophagogastric variceal bleeding in cirrhosis |
title | Analysis of the timing of endoscopic treatment for esophagogastric variceal bleeding in cirrhosis |
title_full | Analysis of the timing of endoscopic treatment for esophagogastric variceal bleeding in cirrhosis |
title_fullStr | Analysis of the timing of endoscopic treatment for esophagogastric variceal bleeding in cirrhosis |
title_full_unstemmed | Analysis of the timing of endoscopic treatment for esophagogastric variceal bleeding in cirrhosis |
title_short | Analysis of the timing of endoscopic treatment for esophagogastric variceal bleeding in cirrhosis |
title_sort | analysis of the timing of endoscopic treatment for esophagogastric variceal bleeding in cirrhosis |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9754091/ https://www.ncbi.nlm.nih.gov/pubmed/36530902 http://dx.doi.org/10.3389/fmed.2022.1036491 |
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