Systematic review with meta‐analysis: incidence of variceal hemorrhage in patients with cirrhosis undergoing transesophageal echocardiography

Autor: Mobolaji Odewole, Ahana Sen, Ehiamen Okoruwa, Sarah R. Lieber, Thomas G. Cotter, Anh D. Nguyen, Arjmand Mufti, Amit G. Singal, Nicole E. Rich
Rok vydání: 2022
Předmět:
Zdroj: Aliment Pharmacol Ther
ISSN: 1365-2036
0269-2813
DOI: 10.1111/apt.16860
Popis: BACKGROUND: The presence of esophageal varices is considered a relative contraindication to transesophageal echocardiography (TEE) by cardiology professional societies, so gastroenterologists are often consulted to perform upper endoscopy prior to TEE in patients with cirrhosis. AIM: Perform a systematic review to quantify the risk of bleeding complications in patients with cirrhosis following TEE METHODS: Two reviewers searched MEDLINE and EMBASE databases from January 1992 to May 2021 for studies reporting bleeding complications from TEE in patients with cirrhosis. We calculated the pooled incidence rate of bleeding events using the metaprop command with a random-effects model. RESULTS: We identified 21 studies comprising 4050 unique patients with cirrhosis; nine studies (n=3015) assessed risk of intraoperative TEE during liver transplant (LT) and twelve studies (n=1035) assessed bleeding risk in patients undergoing TEE for other indications. The pooled incidence of bleeding post-TEE was 0.37% (95%CI 0.04 – 0.94%) across all studies. Bleeding complications were low among patients undergoing TEE during LT as well as those undergoing TEE for other diagnostic reasons (0.97% vs 0.004%) and among studies with mean MELD >18 compared to those with mean MELD
Databáze: OpenAIRE
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