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Clinical features and treatment outcomes of upper gastrointestinal bleeding in patients with cirrhosis

Authors
Seo, Yeon SeokKim, Youn HoAhn, Sang HoonYu, Sang KyunBaik, Soon KooChoi, Sung KyuHeo, JeongHahn, TaehoYoo, Tae WooCho, Se HyunLee, Hyun WoongKim, Ju HyunCho, MongPark, Sang HoonKim, Byung IkHan, Kwang HyubUm, Soon Ho
Issue Date
8월-2008
Publisher
KOREAN ACAD MEDICAL SCIENCES
Keywords
liver cirrhosis; varicose veins; Hemorrhage; Hemostasis; prevention and control; prognosis
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.23, no.4, pp.635 - 643
Indexed
SCIE
SCOPUS
KCI
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume
23
Number
4
Start Page
635
End Page
643
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/122901
DOI
10.3346/jkms.2008.23.4.635
ISSN
1011-8934
Abstract
With recent progress in treatment modalities, mortality from upper gastrointestinal (UGI) bleeding has decreased appreciably. The aim of this study was to establish how UGI bleeds are managed in Korean patients with cirrhosis and to evaluate treatment outcomes. A total of 479 episodes of acute UGI bleeding in 464 patients with cirrhosis were included during a six-month period at nine tertiary medical centers. Treatment outcomes were assessed by failure to control bleeding, rebleeding and mortality. The source of bleeding was esophagogastric varices in 77.7% of patients, nonvariceal lesions in 15.9%, and undefined in 6.5%. For control of bleeding, endoscopic and pharmacologic treatments were used in 74.7% and 81.9% of patients, respectively. Variceal ligation was a major technique for endoscopic treatment (90%), and terlipressin and somatostatin were the main pharmacologic agents used (96.4%). Initial hemostasis was achieved in 86.8% of cases, but rebleeding occurred in 3.8% and 16.8% of cases within five days and six weeks of hemorrhage, respectively. Five-day and six-week mortality were 11.3% and 25.9%, respectively. Survival of patients with variceal bleeding seems to be remarkably improved than previous reports, which may suggest the advances in hemostatic methods for control of variceal hemorrhage.
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