| Predictors of variceal bleed among patients with liver cirrhosis in the era of sclerotherapy. | |
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MedLine Citation:
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PMID: 18363007 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Variceal bleed is a common complication of portal hypertension. The bleed pattern has changed considerably with the introduction of variceal band ligation. The bleed pattern in developing countries where sclerotherapy continues to remain a viable option is not known. The aim of the study was to determine the predictors of first and subsequent bleed in individuals with liver cirrhosis. METHODS: 205 subjects with liver cirrhosis and portal hypertension registered in the liver clinic between January and June 2004, were followed-up for 18 months after registration. Bleeders already on pharmacotherapy or endotherapy were excluded. Patient details included age, gender, duration of illness, aetiology, Child-Pugh-Turcotte score and grades of oesophageal varices, details of index and subsequent variceal bleed, and complications during follow-up. Logistic regression multivariate analysis was applied to predict the factors influencing variceal bleed. RESULTS: There were 95 variceal bleeders and 110 non-bleeders. Age at presentation and gender did not predict a variceal bleed. Grades III and IV oesophageal varices and fundal varices were the significant risk factors for an index bleed (p-value is 0.001). 27 of the 95 bleeders (28.3 percent) had a second bleed after a mean interval of 8 (+/- 7.7) months. Predictors of rebleed were similar to the index bleed. Predictors of index bleed were also similar to those who had bled for the first time after registration. Overall bleed-related mortality was low (2.1 percent). CONCLUSION: Higher grades of varices, presence of cherry-red spots and fundal varices predicted variceal bleed in patients with liver cirrhosis. Variceal bleed-related mortality was low in the era of sclerotherapy. |
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Authors:
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J Varghese; J V Cherian; R Solomon; V Jayanthi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Singapore medical journal Volume: 49 ISSN: 0037-5675 ISO Abbreviation: Singapore Med J Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-03-25 Completed Date: 2008-05-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0404516 Medline TA: Singapore Med J Country: Singapore |
Other Details:
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Languages: eng Pagination: 239-42 Citation Subset: IM |
Affiliation:
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Department of Medical Gastroenterology, Stanley Medical College Hospital, Old Jail Road, Royapuram, Chennai 600001, Tamil Nadu, India. joyvargese@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Developing Countries Esophageal and Gastric Varices / complications*, etiology, therapy Female Gastrointestinal Hemorrhage / etiology* Humans Hypertension, Portal / complications*, etiology Ligation Liver Cirrhosis / complications* Logistic Models Male Prognosis Prospective Studies Risk Factors Sclerotherapy / instrumentation, methods* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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