Clinical features and outcomes of gastric variceal bleeding: retrospective Korean multicenter dataClinical features and outcomes of gastric variceal bleeding: retrospective Korean multicenter data
- Other Titles
- Clinical features and outcomes of gastric variceal bleeding: retrospective Korean multicenter data
- Authors
- 김문영; 엄순호; 백순구; 서연석; 박수영; 이정일; 이진우; 천갑진; 손주현; 김태엽; 임영석; 김태효; 이태희; 박성재; 박승하; 김진동; 한상영; 최창수; 조은영; 김동준; 황재석; 장병국; 이준성; 김상균; 김영석; 권소영; 최원혁; 이창형; 김병석; 장재영; 정승원; 김병호; 심재준; 조용균; 고문수; 이현웅
- Issue Date
- 2013
- Publisher
- 대한간학회
- Keywords
- Gastric variceal bleeding; Rebleeding; Mortality; Cirrhosis
- Citation
- Clinical and Molecular Hepatology, v.19, no.1, pp.36 - 44
- Indexed
- SCOPUS
KCI
- Journal Title
- Clinical and Molecular Hepatology
- Volume
- 19
- Number
- 1
- Start Page
- 36
- End Page
- 44
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/105124
- DOI
- 10.3350/cmh.2013.19.1.36
- ISSN
- 2287-2728
- Abstract
- Background/Aims: While gastric variceal bleeding (GVB) is not as prevalent as esophageal variceal bleeding, it is reportedly more serious, with high failure rates of the initial hemostasis (>30%), and has a worse prognosis than esophageal variceal bleeding. However, there is limited information regarding hemostasis and the prognosis for GVB.
The aim of this study was to determine retrospectively the clinical outcomes of GVB in a multicenter study in Korea.
Methods: The data of 1,308 episodes of GVB (males:females=1062:246, age=55.0±11.0 years, mean±SD) were collected from 24 referral hospital centers in South Korea between March 2003 and December 2008. The rates of initial hemostasis failure, rebleeding, and mortality within 5 days and 6 weeks of the index bleed were evaluated.
Results: The initial hemostasis failed in 6.1% of the patients, and this was associated with the Child-Pugh score [odds ratio (OR)=1.619; P<0.001] and the treatment modality: endoscopic variceal ligation, endoscopic variceal obturation,and balloon-occluded retrograde transvenous obliteration vs. endoscopic sclerotherapy, transjugular intrahepatic portosystemic shunt, and balloon tamponade (OR=0.221, P<0.001). Rebleeding developed in 11.5% of the patients, and was significantly associated with Child-Pugh score (OR=1.159, P<0.001) and treatment modality (OR=0.619, P=0.026). The GVB-associated mortality was 10.3%; mortality in these cases was associated with Child-Pugh score (OR=1.795, P<0.001)and the treatment modality for the initial hemostasis (OR=0.467, P=0.001).
Conclusions: The clinical outcome for GVB was better for the present cohort than in previous reports. Initial hemostasis failure, rebleeding, and mortality due to GVB were universally associated with the severity of liver cirrhosis. (Clin Mol Hepatol 2013;19:36-44)
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