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Early rebleeding and death at 6 weeks in alcoholic cirrhotic patients with acute variceal bleeding treated with emergency endoscopic injection sclerotherapy.
S Afr J Surg. 2009 Aug; 47(3):72-4, 76-9.SA

Abstract

BACKGROUND

This study evaluated the incidence of rebleeding and death at 6 weeks after a first episode of acute variceal haemorrhage (AVH) treated by emergency endoscopic sclerotherapy in a large cohort of alcoholic cirrhotic patients.

METHODS

From January 1984 to December 2006, 310 alcoholic cirrhotic patients (242 men, 68 women; mean age 51.7 years) with AVH underwent 786 endoscopic variceal injection treatments (342 emergency, 444 elective) during 919 endoscopy sessions in the first 6 weeks after the first variceal bleed. Endoscopic control of initial bleeding, variceal rebleeding and survival at 6 weeks were recorded.

RESULTS

Endoscopic intervention controlled AVH in 304 of 310 patients (98.1%). Seventy-five patients (24.2%) rebled, 38 (12.3%) within 5 days and 37 (11.9%) within 6 weeks. No patient scored as Child-Pugh A died. Seventy-seven (24.8%) Child-Pugh B and C patients died, 29 (9.3%) within 5 days and 48 (15.4%) between 6 and 42 days. Mortality increased exponentially as the Child-Pugh score increased, reaching 80% when the score exceeded 13.

CONCLUSION

Despite initial control of variceal haemorrhage, 1 in 4 patients (24.2%) rebled within 6 weeks. Survival at 6 weeks was 75.2% and was influenced by the severity of liver failure, with most deaths occurring in Child-Pugh grade C patients.

Authors+Show Affiliations

Department of Surgery and MRC Liver Research Centre, University of Cape Town Faculty of Health Sciences and Surgical Gastroenterology Unit, Groote Schuur Hospital, Cape Town.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19813442

Citation

Krige, J E J., et al. "Early Rebleeding and Death at 6 Weeks in Alcoholic Cirrhotic Patients With Acute Variceal Bleeding Treated With Emergency Endoscopic Injection Sclerotherapy." South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie, vol. 47, no. 3, 2009, pp. 72-4, 76-9.
Krige JE, Shaw JM, Bornman PC, et al. Early rebleeding and death at 6 weeks in alcoholic cirrhotic patients with acute variceal bleeding treated with emergency endoscopic injection sclerotherapy. S Afr J Surg. 2009;47(3):72-4, 76-9.
Krige, J. E., Shaw, J. M., Bornman, P. C., & Kotze, U. K. (2009). Early rebleeding and death at 6 weeks in alcoholic cirrhotic patients with acute variceal bleeding treated with emergency endoscopic injection sclerotherapy. South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie, 47(3), 72-4, 76-9.
Krige JE, et al. Early Rebleeding and Death at 6 Weeks in Alcoholic Cirrhotic Patients With Acute Variceal Bleeding Treated With Emergency Endoscopic Injection Sclerotherapy. S Afr J Surg. 2009;47(3):72-4, 76-9. PubMed PMID: 19813442.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early rebleeding and death at 6 weeks in alcoholic cirrhotic patients with acute variceal bleeding treated with emergency endoscopic injection sclerotherapy. AU - Krige,J E J, AU - Shaw,J M, AU - Bornman,P C, AU - Kotze,U K, PY - 2009/10/10/entrez PY - 2009/10/10/pubmed PY - 2009/10/29/medline SP - 72-4, 76-9 JF - South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie JO - S Afr J Surg VL - 47 IS - 3 N2 - BACKGROUND: This study evaluated the incidence of rebleeding and death at 6 weeks after a first episode of acute variceal haemorrhage (AVH) treated by emergency endoscopic sclerotherapy in a large cohort of alcoholic cirrhotic patients. METHODS: From January 1984 to December 2006, 310 alcoholic cirrhotic patients (242 men, 68 women; mean age 51.7 years) with AVH underwent 786 endoscopic variceal injection treatments (342 emergency, 444 elective) during 919 endoscopy sessions in the first 6 weeks after the first variceal bleed. Endoscopic control of initial bleeding, variceal rebleeding and survival at 6 weeks were recorded. RESULTS: Endoscopic intervention controlled AVH in 304 of 310 patients (98.1%). Seventy-five patients (24.2%) rebled, 38 (12.3%) within 5 days and 37 (11.9%) within 6 weeks. No patient scored as Child-Pugh A died. Seventy-seven (24.8%) Child-Pugh B and C patients died, 29 (9.3%) within 5 days and 48 (15.4%) between 6 and 42 days. Mortality increased exponentially as the Child-Pugh score increased, reaching 80% when the score exceeded 13. CONCLUSION: Despite initial control of variceal haemorrhage, 1 in 4 patients (24.2%) rebled within 6 weeks. Survival at 6 weeks was 75.2% and was influenced by the severity of liver failure, with most deaths occurring in Child-Pugh grade C patients. SN - 0038-2361 UR - https://www.unboundmedicine.com/medline/citation/19813442/Early_rebleeding_and_death_at_6_weeks_in_alcoholic_cirrhotic_patients_with_acute_variceal_bleeding_treated_with_emergency_endoscopic_injection_sclerotherapy_ L2 - https://medlineplus.gov/gastrointestinalbleeding.html DB - PRIME DP - Unbound Medicine ER -