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. 2022 Dec 1:9:1036491.
doi: 10.3389/fmed.2022.1036491. eCollection 2022.

Analysis of the timing of endoscopic treatment for esophagogastric variceal bleeding in cirrhosis

Kaini Wu  1 , Yunfeng Fu  1 , Zixiang Guo  1 , Xiaodong Zhou  1
Affiliations

Analysis of the timing of endoscopic treatment for esophagogastric variceal bleeding in cirrhosis

Kaini Wu et al. Front Med (Lausanne). .

Abstract

Background: Existing guidelines recommend endoscopic treatment within 12 h or 12-24 h for patients with esophagogastric variceal bleeding (EGVB) in cirrhosis. In addition, research findings on the optimal time for endoscopy are inconsistent.

Aim: The aim of this study was to investigate the relationship between the timing of endoscopy and clinical outcomes in cirrhotic patients with EGVB and to analyze the risk factors for the composite outcomes after endoscopic treatment.

Methods: From January 2019 to June 2020, 456 patients with cirrhotic EGVB who underwent endoscopy were matched by a 1:1 propensity score. Finally, 266 patients were divided into two groups, including 133 patients within 12 h (urgent endoscopy group) of admission and after 12 h (non-urgent endoscopy group). Baseline data and clinical outcomes were compared. Logistic regression model analysis was used to determine risk factors for 30 days rebleeding and mortality.

Results: In 266 patients, the overall 30 days rebleeding rate and mortality were 10.9% (n = 29) and 3.4% (n = 9), respectively. Patients who underwent endoscopic treatment within 12 h had significantly higher 30 days rebleeding outcomes than those who underwent treatment beyond 12 h (15 vs. 6.8%, p = 0.003). However, 30 days mortality did not differ significantly between the two groups (3 vs. 3.8%, p = 0.736). Logistic regression analysis showed that age and shock on admission were independent risk factors for the composite outcome of 30 days rebleeding and mortality in patients with EGVB.

Conclusion: The 30 days rebleeding rate in patients with cirrhotic EGVB treated with urgent endoscopy was significantly higher than that in patients treated with non-urgent endoscopy, but there was no significant difference in 30 days mortality.

Keywords: cirrhosis; endoscopy; esophagogastric variceal bleeding; risk factor; timing.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Kaplan–Meier estimates of 30 days rebleeding in patients with acute variceal bleeding before propensity score matching.
FIGURE 2
FIGURE 2
Kaplan–Meier estimates of 30 days rebleeding in patients with acute variceal bleeding after propensity score matching.
See this image and copyright information in PMC

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