Document Detail

A prospective study of the ability of three endoscopic classifications to predict hemorrhage from esophageal varices.
MedLine Citation:
PMID:  1511815     Owner:  NLM     Status:  MEDLINE    
Hemorrhage from esophageal varices in cirrhotics is a frequent event with high mortality in spite of therapy. Preventive sclerotherapy seems to be beneficial only if the patient's bleeding risk is higher than 40 to 50% a year. A series of 320 patients with esophageal varices without previous bleeding was studied prospectively; the varices were classified according to three widely used endoscopic classifications. During follow-up (6 to 36 months, average 14 months), hemorrhage occurred in 49 patients (15.3%) of whom 30 (61.2%) bled from varices (8.2 and 11.0% at 12 and 24 months, respectively). At the same time intervals, mortality of the entire population studied was 18.0 and 23.8%, respectively, of which one third was directly due to hemorrhage. With all three classifications, the higher the degree of bleeding risk, the greater the actual percentage of hemorrhages recorded; however, it never reached 40% a year. In predicting the bleeding event, Dagradi's classification proved more sensitive than JRSPH or NIEC, but the latter classifications were more specific and assessed a higher predictive value for a positive test. Endoscopic observation probably needs integration with other methods if a reliable bleeding prediction is to be made.
G P Rigo; A Merighi; N J Chahin; M Mastronardi; P L Codeluppi; A Ferrari; C Armocida; G Zanasi; A Cristani; G Cioni
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  38     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:    1992 Jul-Aug
Date Detail:
Created Date:  1992-09-25     Completed Date:  1992-09-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  425-9     Citation Subset:  IM    
Gastroenterology and Digestive Endoscopy, University of Modena, Italy.
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MeSH Terms
Esophageal and Gastric Varices / classification,  diagnosis,  epidemiology*
Follow-Up Studies
Gastrointestinal Hemorrhage / epidemiology*
Life Tables
Middle Aged
Predictive Value of Tests
Prospective Studies
Risk Factors
Sensitivity and Specificity
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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