| Diagnostic performance of Baveno IV criteria in cirrhotic patients with upper gastrointestinal bleeding: analysis of the F7 liver-1288 study population. | |
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MedLine Citation:
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PMID: 20817301 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND & AIMS: The definition of failure to control bleeding agreed upon at the Baveno IV consensus meeting, included the Adjusted Blood Requirement Index [ABRI: number of blood units/(final-initial hematocrit+0.01)]. ABRI ≥0.75 denotes failure. However, timing for hematocrit measurements was not defined. The aims of this study were: (1) to assess the Baveno IV criteria performance to classify treatment success or failure to control bleeding at 5 days, (2) to determine the appropriate timing for hematocrit. METHODS: Two hundred and forty-two cirrhotic patients with gastrointestinal bleeding were independently classified by three clinical experts according to the Baveno IV criteria, by analysis of the database of a randomized trial. ABRI was calculated by using the closest hematocrit to the 5 day time point from the first trial product administration (ABRI-1) or after the latest transfusion within the 5-day period (ABRI-2). The gold standard for success/failure for 5-day control of bleeding was the clinical judgment of the three independent observers based on all the clinical and follow-up data. RESULTS: Inter-observer agreement for the final outcome assessment was 0.82 and a final consensus was obtained in 236/242 patients. Inter-observer agreement on patient classification with Baveno IV criteria was 0.70 with ABRI-1 and 0.84 with ABRI-2. c-statistics for correct patients classification were 0.86 for ABRI-1, 0.84 for ABRI-2, and 0.88 for Baveno IV criteria without ABRI. ABRI-1 caused misclassification of 27 patients and ABRI-2 of 39. CONCLUSIONS: Baveno IV criteria are accurate to assess outcome of patients with variceal bleeding. There is a substantial observer variability linked to timing of hematocrits for ABRI calculation. With the current definition ABRI does not add to the performance of the other criteria. |
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Authors:
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D Thabut; G D'Amico; P Tan; R De Franchis; S Fabricius; D Lebrec; J Bosch; F Bendtsen |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2010-08-12 |
Journal Detail:
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Title: Journal of hepatology Volume: 53 ISSN: 1600-0641 ISO Abbreviation: J. Hepatol. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-02 Completed Date: 2011-02-24 Revised Date: 2012-08-24 |
Medline Journal Info:
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Nlm Unique ID: 8503886 Medline TA: J Hepatol Country: England |
Other Details:
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Languages: eng Pagination: 1029-34 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. |
Affiliation:
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UPMC, AP-HP, Service d'Hépato-Gastroentérologie, Hôpital Pitié-Salpêtrière, Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Transfusion Esophageal and Gastric Varices / complications Factor VIIa / therapeutic use Female Gastrointestinal Hemorrhage / blood, complications*, diagnosis*, therapy Hematocrit Humans Hypertension, Portal / complications Liver Cirrhosis / complications* Male Middle Aged Recombinant Proteins / therapeutic use Retrospective Studies Time Factors Treatment Failure Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Recombinant Proteins; 0/recombinant FVIIa; EC 3.4.21.21/Factor VIIa |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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