Comparison of clinical outcomes between variceal and non-variceal gastrointestinal bleeding in patients with cirrhosis
| Autor: | Stacey Fisher, Kirles Bishay, Erin Kelly, Parul Tandon, Dominique Yelle, I Carrigan, Krista Wooller |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Gastrointestinal bleeding Cirrhosis Hepatology business.industry Gastroenterology Retrospective cohort study medicine.disease Intensive care unit law.invention 03 medical and health sciences 0302 clinical medicine Esophageal varices Interquartile range law 030220 oncology & carcinogenesis Internal medicine medicine Portal hypertension 030211 gastroenterology & hepatology Varices business |
| Zdroj: | Journal of Gastroenterology and Hepatology. 33:1773-1779 |
| ISSN: | 0815-9319 |
| DOI: | 10.1111/jgh.14147 |
| Popis: | Background and aim Acute upper gastrointestinal bleeding (UGIB) in cirrhosis is associated with significant morbidity and mortality and can be classified as acute variceal bleeding (AVB) or non-variceal bleeding (NVB). Differences in mortality, hospital length of stay (LOS), and 30-day readmission have yet to be determined. As such, the study aimed to evaluate differences in these clinical outcomes in cirrhotic patients admitted with UGIB. Methods This retrospective study included all cirrhotic patients hospitalized for UGIB who underwent upper endoscopy from July 2014 to July 2016. AVB was defined as the presence of varices on endoscopy with high-risk stigmata such as cherry-red spots. Mortality, intensive care unit admission, hospital LOS, and 30-day hospital readmission were recorded and compared among patients with AVB and NVB. Results A total of 116 patients with cirrhosis were included, 73 with AVB and 43 with NVB. Patients with NVB were older than those with AVB (60.4 ± 11.1 vs 55.0 ± 9.5, P = 0.006) whereas patients with AVB were more likely to have known esophageal varices (64.4% vs 37.2%, P = 0.007). Patients with AVB and NVB had similar mortality (15.1% vs 9.3%, P = 0.57), hospital LOS (4.9, interquartile range: 3.6-6.9 days vs 5.0, interquartile range: 2.7-8.3 days), and 30-day readmission rates (19.2% vs 30.2%, P = 0.18). Severity of clinical presentation was associated with increased LOS and overall mortality, including the need for intensive care unit admission, but these were not associated with 30-day readmission rates. Conclusion There were no differences in clinical outcomes, including mortality, in cirrhotic patients admitted with AVB and NVB. |
| Databáze: | OpenAIRE |
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