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Survival after endoscopic sclerotherapy for esophageal varices in cirrhotics.
Am J Gastroenterol. 1994 Oct; 89(10):1815-22.AJ

Abstract

OBJECTIVES

Gastroesophageal bleeding from varices is the most life-threatening complication in liver cirrhosis with portal hypertension. Since its first application, endoscopic sclerotherapy seems to be the most widely applicable procedure to stop the bleeding and to prevent recurrences. The aim of this study was to ascertain the role of some factors as predictors of survival in different groups of cirrhotic patients.

METHODS

At the time of their first hemorrhage from esophageal varices, 184 patients with portal hypertension from cirrhosis were treated by endoscopic sclerotherapy using a combined intraparavariceal procedure and Polidocanol 1% as sclerosing agent.

RESULTS

The follow-up range was 1-106 months (mean, 28.2 months), and 84 patients were still alive (45.7%), 97 had died (52.7%), and three had withdrawn (1.6%) at the end of the period. The major cause of death was bleeding, and 35 patients died in the first 6 wk after sclerotherapy. Using Cox proportional hazard models, Child's grading was the most important prognostic factor of both short-term (first 6 wk) and medium/long-term survival (after the first 6 wk up to 5 years). Complete eradication of varices, too, was associated with both short- and long-term survival, whereas age, sex, etiology of cirrhosis, and the presence of esophageal stenosis as a side effect of sclerotherapy were not. The type of sclerotherapy (elective vs emergent) was associated with survival, but it was not independent from Child's grade, because only patients in Child C treated electively showed a better prognosis than those treated in emergency.

CONCLUSIONS

We can conclude that patients with severe liver disease (Class C) have poor prognosis, and complete eradication represents an aim because it seems to be protective against the risk of dying.

Authors+Show Affiliations

Department of Internal Medicine, S. Orsola FBF Hospital, Brescia, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7942674

Citation

Graffeo, M, et al. "Survival After Endoscopic Sclerotherapy for Esophageal Varices in Cirrhotics." The American Journal of Gastroenterology, vol. 89, no. 10, 1994, pp. 1815-22.
Graffeo M, Buffoli F, Lanzani G, et al. Survival after endoscopic sclerotherapy for esophageal varices in cirrhotics. Am J Gastroenterol. 1994;89(10):1815-22.
Graffeo, M., Buffoli, F., Lanzani, G., Donato, F., Cesari, P., Benedini, D., Rolfi, F., & Paterlini, A. (1994). Survival after endoscopic sclerotherapy for esophageal varices in cirrhotics. The American Journal of Gastroenterology, 89(10), 1815-22.
Graffeo M, et al. Survival After Endoscopic Sclerotherapy for Esophageal Varices in Cirrhotics. Am J Gastroenterol. 1994;89(10):1815-22. PubMed PMID: 7942674.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Survival after endoscopic sclerotherapy for esophageal varices in cirrhotics. AU - Graffeo,M, AU - Buffoli,F, AU - Lanzani,G, AU - Donato,F, AU - Cesari,P, AU - Benedini,D, AU - Rolfi,F, AU - Paterlini,A, PY - 1994/10/1/pubmed PY - 1994/10/1/medline PY - 1994/10/1/entrez SP - 1815 EP - 22 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 89 IS - 10 N2 - OBJECTIVES: Gastroesophageal bleeding from varices is the most life-threatening complication in liver cirrhosis with portal hypertension. Since its first application, endoscopic sclerotherapy seems to be the most widely applicable procedure to stop the bleeding and to prevent recurrences. The aim of this study was to ascertain the role of some factors as predictors of survival in different groups of cirrhotic patients. METHODS: At the time of their first hemorrhage from esophageal varices, 184 patients with portal hypertension from cirrhosis were treated by endoscopic sclerotherapy using a combined intraparavariceal procedure and Polidocanol 1% as sclerosing agent. RESULTS: The follow-up range was 1-106 months (mean, 28.2 months), and 84 patients were still alive (45.7%), 97 had died (52.7%), and three had withdrawn (1.6%) at the end of the period. The major cause of death was bleeding, and 35 patients died in the first 6 wk after sclerotherapy. Using Cox proportional hazard models, Child's grading was the most important prognostic factor of both short-term (first 6 wk) and medium/long-term survival (after the first 6 wk up to 5 years). Complete eradication of varices, too, was associated with both short- and long-term survival, whereas age, sex, etiology of cirrhosis, and the presence of esophageal stenosis as a side effect of sclerotherapy were not. The type of sclerotherapy (elective vs emergent) was associated with survival, but it was not independent from Child's grade, because only patients in Child C treated electively showed a better prognosis than those treated in emergency. CONCLUSIONS: We can conclude that patients with severe liver disease (Class C) have poor prognosis, and complete eradication represents an aim because it seems to be protective against the risk of dying. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/7942674/Survival_after_endoscopic_sclerotherapy_for_esophageal_varices_in_cirrhotics_ L2 - http://www.diseaseinfosearch.org/result/2658 DB - PRIME DP - Unbound Medicine ER -