Clinical features and outcomes of gastric variceal bleeding: retrospective Korean multicenter data

Authors
Moon Young KimSoon Ho UmSoon Koo BaikYeon Seok SeoSoo Young ParkJung Il LeeJin Woo LeeGab Jin CheonJoo Hyun SohnTae Yeob KimYoung Suk LimTae Hyo KimTae Hee LeeSung Jae ParkSeung Ha ParkJin Dong KimSang Young HanChang Soo ChoiEun Young ChoDong Joon KimJae Seok HwangByoung Kuk JangJune Sung LeeSang Gyune KimYoung Seok KimSo Young KwonWon Hyeok ChoeChang Hyeong LeeByung Seok KimJae Young JangSoung Won JeongByung Ho KimJae Jun ShimYong Kyun ChoMoon Soo KohHyun Woong Lee
Department
Dept. of Internal Medicine (내과학)
Issue Date
2013
Citation
Clinical and Molecular Hepatology, Vol.19(1) : 36-44, 2013
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. Keywords: Gastric variceal bleeding, Rebleeding, Mortality, Cirrhosis
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/35438
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
Keimyung Author(s)
황재석; 장병국
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