Timing of upper gastrointestinal endoscopy does not influence short-term outcomes in patients with acute variceal bleeding  

作　　者：Jeong-Ju Yoo Young Chang Eun Ju Cho Ji Eun Moon Sang Gyune Kim Young Seok Kim Yun Bin Lee Jeong-Hoon Lee Su Jong Yu Yoon Jun Kim Jung-Hwan Yoon 

机构地区：[1]Department of Gastroenterology and Hepatology, Soonchunhyang University school of Medicine, Bucheon 14584, South Korea [2]Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea [3]Department of Biostatistics, Clinical Trial Center, Soonchunhyang University Bucheon Hospital, Bucheon 14584, South Korea

出　　处：《World Journal of Gastroenterology》2018年第44期5025-5033,共9页世界胃肠病学杂志（英文版）

摘　　要：AIM To examine the association between the timing of endo-scopy and the short-term outcomes of acute variceal bleeding in cirrhotic patients.METHODS This retrospective study included 274 consecutive patients admitted with acute esophageal variceal bleeding of two tertiary hospitals in Korea. We adjusted confounding factors using the Cox proportional hazards model and the inverse probability weighting （IPW） method. The primary outcome was the mortality of patients within 6 wk.RESULTS A total of 173 patients received urgent endoscopy （ i.e. , ≤ 12 h after admission）, and 101 patients received non-urgent endoscopy （〉 12 h after admission）. The 6-wk mortality rate was 22.5% in the urgent endoscopy group and 29.7% in the non-urgent endoscopy group, and there was no significant difference between the two groups before （P = 0.266） and after IPW （P = 0.639）. The length of hospital stay was statistically different between the urgent group and non-urgent group （P = 0.033）; however, there was no significant difference in the in-hospital mortality rate between the two groups （8.1%vs 7.9%, P = 0.960）. In multivariate analyses, timing of endoscopy was not associated with 6-wk mortality （hazard ratio, 1.297; 95% confdence interval, 0.806-2.089; P = 0.284）.CONCLUSION In cirrhotic patients with acute variceal bleeding, the timing of endoscopy may be independent of short-term mortality.AIM To examine the association between the timing of endoscopy and the short-term outcomes of acute variceal bleeding in cirrhotic patients.METHODS This retrospective study included 274 consecutive patients admitted with acute esophageal variceal bleeding of two tertiary hospitals in Korea. We adjusted confounding factors using the Cox proportional hazards model and the inverse probability weighting(IPW) method. The primary outcome was the mortality of patients within 6 wk.RESULTS A total of 173 patients received urgent endoscopy(i.e., ≤ 12 h after admission), and 101 patients received nonurgent endoscopy(> 12 h after admission). The 6-wk mortality rate was 22.5% in the urgent endoscopy group and 29.7% in the non-urgent endoscopy group, and there was no significant difference between the two groups before(P = 0.266) and after IPW(P = 0.639). The length of hospital stay was statistically different between the urgent group and non-urgent group(P = 0.033); however, there was no significant difference in the inhospital mortality rate between the two groups(8.1% vs 7.9%, P = 0.960). In multivariate analyses, timing of endoscopy was not associated with 6-wk mortality(hazard ratio, 1.297; 95% confidence interval, 0.806-2.089; P = 0.284).CONCLUSION In cirrhotic patients with acute variceal bleeding, the timing of endoscopy may be independent of short-term mortality.

关 键 词：CIRRHOSIS ENDOSCOPY Upper gastrointestinal bleeding Gastroesophageal varices TIMING 

分 类 号：R575.2[医药卫生—消化系统]