Document Detail

Risk factors for bleeding complications after endoscopic variceal ligation therapy.
MedLine Citation:
PMID:  20886424     Owner:  NLM     Status:  In-Process    
BACKGROUND: Bleeding from esophageal varices is a severe complication of portal hypertension. Endoscopic band ligation (EBL) is the treatment of choice for acute variceal bleeding. It is also performed for primary and secondary prophylaxis of bleeding from esophageal varices. After EBL, patients are at risk of postinterventional bleeding; the risk factors for this complication are poorly evaluated.
METHODS: We retrospectively analyzed data from patients who underwent EBL. We evaluated clinical data, laboratory and endoscopic findings.
RESULTS: 255 patients with 387 ligation sessions were included in the analysis. Patients with bleeding complications had a significantly higher severity of liver disease as measured by a higher Child-Pugh score (10.5 vs. 8, p = 0.002), lower albumin (26.5 vs. 31.9 [g/L], p = 0.0001) and lower prothrombin activity (46.5 vs. 70 [%], p = 0.0001). The incidence of bacterial infection was significantly higher in patients with postinterventional bleeding. As well, the white blood cell count was significantly higher in the bleeding group (9.5 vs. 6.5 [× 10 (9) /L], p = 0.030). In patients with bleeding events we observed an elevated heart rate compared to those without this complication (80 vs. 72 [bpm], p = 0.017). Furthermore, we found a lower hemoglobin level (5.9 vs. 6.4 [mmol/L], p = 0.028) and a lower hematocrit (0.280 vs. 0.314, p = 0.031) in the bleeding group. Younger patients suffered more often from postinterventional bleeding (52.5 vs. 58 [years], p = 0.012).
CONCLUSION: There are clinical data which can be ascertained easily in order to reflect the risk of bleeding complications after EBL.
J Grothaus; F Petrasch; S Zeynalova; J Mössner; I Schiefke; A Hoffmeister
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Publication Detail:
Type:  Journal Article     Date:  2010-09-30
Journal Detail:
Title:  Zeitschrift für Gastroenterologie     Volume:  48     ISSN:  1439-7803     ISO Abbreviation:  Z Gastroenterol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0033370     Medline TA:  Z Gastroenterol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1200-6     Citation Subset:  IM    
Copyright Information:
© Georg Thieme Verlag KG Stuttgart · New York.
Department of Internal Medicine II, University of Leipzig, Leipzig, Germany.
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