A creatinine-based model for predicting recurrent bleeding after modified percutaneous transhepatic variceal embolization in patients with cirrhosis

Ji, Kun; Li, Xin; Zhu, Hongyi; Zhao, Si; Zhan, Pengchao; Shi, Yang; Ye, Shu-Wen; Xie, Bing-Can; Zhang, Yuyuan; Yu, Peng; Ren, Zhigang; Ding, Juan; Han, Xinwei; Li, Zhen

doi:10.1016/j.jimed.2022.03.007

Cited by 3 publications

(2 citation statements)

References 31 publications

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“…Previous study has reported that gastric variceal has a high rebleeding rate of 34% -89% in glue extrusion period [32]. Apart from these, gastric varices, encephalopathy (meaningful in univariate analysis and not meaningful in multifactorial logistic analysis in our study), portal thrombosis, HCC, large varices, active bleeding during endoscopy, and a high HVPG have been found to increase in early rebleeding [33,34].…”

Section: Discussionmentioning

confidence: 39%

Risk factors and predictive nomograms of bedside emergency endoscopic treatment of esophagogastric variceal bleeding in cirrhotic patients with endotracheal intubation

Zeng,

Li,

Lyu

et al. 2023

Preprint

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The data on the clinical practice of emergency endoscopic therapy following endotracheal intubation in remain limited. In this retrospective study, we aimed to explore the efficacy and risk factors of bedside emergency endoscopic treatment following endotracheal intubation in (EGVB) patients. The included EGVB patients were allocated to training and validation sets in a randomly stratified manner. Univariate and multivariate logistic regression analyses were used to identify independent risk factors to construct nomograms for predict the prognosis related to endoscopic hemostasis failure rate and 6-week mortality. In result, WBC (p = 0.03), CTP score (p= 0.001) and comorbid shock (p= 0.005) were selected as independent clinical predictors of endoscopic hemostasis failure. High CTP score (p = 0.003) and gastric varices (p= 0.009) were related to early rebleeding after emergency endoscopic treatment. Furthermore, the 6-week mortality was significantly associated with MELD scores (p = 0.002), the presence of hepatic encephalopathy (p=0.045) and postoperative rebleeding (p< 0.001). Finally, we developed practical nomograms to discern the risk of the emergency endoscopic hemostasis failure and 6-week mortality for EGVB patients, which may help identify high-risk patients for earlier implementation of aggressive treatments.

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Section: Discussionmentioning

confidence: 39%

Risk factors and predictive nomograms of bedside emergency endoscopic treatment of esophagogastric variceal bleeding in cirrhotic patients with endotracheal intubation

Zeng,

Li,

Lyu

et al. 2023

Preprint

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“…A previous study reported that gastric variceal had a high rebleeding rate of 34–89% during glue extrusion period 32 . Apart from these, gastric varices, encephalopathy (meaningful in univariate analysis and not meaningful in multifactorial logistic analysis in our study), portal thrombosis, HCC, large varices, active bleeding during endoscopy, and a high HVPG levels have been found to increase the risk of in early rebleeding 33 , 34 .…”

Section: Discussionmentioning

confidence: 50%

Risk factors and predictive nomograms for bedside emergency endoscopic treatment following endotracheal intubation in cirrhotic patients with esophagogastric variceal bleeding

Zeng,

Li,

Lyu

et al. 2024

Sci Rep

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Data on emergency endoscopic treatment following endotracheal intubation in patients with esophagogastric variceal bleeding (EGVB) remain limited. This retrospective study aimed to explore the efficacy and risk factors of bedside emergency endoscopic treatment following endotracheal intubation in severe EGVB patients admitted in Intensive Care Unit. A total of 165 EGVB patients were enrolled and allocated to training and validation sets in a randomly stratified manner. Univariate and multivariate logistic regression analyses were used to identify independent risk factors to construct nomograms for predicting the prognosis related to endoscopic hemostasis failure rate and 6-week mortality. In result, white blood cell counts (p = 0.03), Child-Turcotte-Pugh (CTP) score (p = 0.001) and comorbid shock (p = 0.005) were selected as independent clinical predictors of endoscopic hemostasis failure. High CTP score (p = 0.003) and the presence of gastric varices (p = 0.009) were related to early rebleeding after emergency endoscopic treatment. Furthermore, the 6-week mortality was significantly associated with MELD scores (p = 0.002), the presence of hepatic encephalopathy (p = 0.045) and postoperative rebleeding (p < 0.001). Finally, we developed practical nomograms to discern the risk of the emergency endoscopic hemostasis failure and 6-week mortality for EGVB patients. In conclusion, our study may help identify severe EGVB patients with higher hemostasis failure rate or 6-week mortality for earlier implementation of salvage treatments.

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Efficacy of transjugular intrahepatic portosystemic shunts in treating cirrhotic esophageal-gastric variceal bleeding

Hu,

Dai,

et al. 2024

World J Gastrointest Surg

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BACKGROUND Esophageal-gastric variceal bleeding (EGVB) represents a severe complication among patients with cirrhosis and often culminates in fatal outcomes. Interventional therapy, a rapidly developing treatment modality over the past few years, has found widespread application in clinical practice due to its minimally invasive characteristics. However, whether transjugular intrahepatic portosystemic shunt (TIPS) treatment has an impact on patient prognosis remains controversial. AIM To probing the efficacy of TIPS for treating cirrhotic EGVB and its influence on the prognosis of patients afflicted by this disease. METHODS A retrospective study was conducted on ninety-two patients presenting with cirrhotic EGVB who were admitted to our hospital between September 2020 and September 2022. Based on the different modes of treatment, the patients were assigned to the study group (TIPS received, n = 50) or the control group (percutaneous transhepatic varices embolization received, n = 42). Comparative analyses were performed between the two groups preoperatively and one month postoperatively for the following parameters: Varicosity status; hemodynamic parameters [portal vein flow velocity (PVV) and portal vein diameter (PVD); platelet count (PLT); red blood cell count; white blood cell count (WBC); and hepatic function [albumin (ALB), total bilirubin (TBIL), and aspartate transaminase (AST)]. The Generic Quality of Life Inventory-74 was utilized to assess quality of life in the two groups, and the 1-year postoperative rebleeding and survival rates were compared. RESULTS Following surgical intervention, there was an improvement in the incidence of varicosity compared to the preoperative status in both cohorts. Notably, the study group exhibited more pronounced enhancements than did the control group (P < 0.05). PVV increased, and PVD decreased compared to the preoperative values, with the study cohort achieving better outcomes (P < 0.05). PLT and WBC counts were elevated postoperatively in the two groups, with the study cohort displaying higher PLT and WBC counts (P < 0.05). No differences were detected between the two groups in terms of serum ALB, TBIL, or AST levels either preoperatively or postoperatively (P < 0.05). Postoperative scores across all dimensions of life quality surpassed preoperative scores, with the study cohort achieving higher scores (P < 0.05). At 22.00%, the one-year postoperative rebleeding rate in the study cohort was significantly lower than that in the control group (42.86%; P < 0.05); conversely, no marked difference was observed in the 1-year postoperative survival rate between the two cohorts (P > 0.05). CONCLUSION TIPS, which has demonstrated robust efficacy in managing cirrhotic EGVB, remarkably alleviates varicosity and improves hemodynamics in patients. This intervention not only results in a safer profile but also contributes significantly to a more favorable prognosis.

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A creatinine-based model for predicting recurrent bleeding after modified percutaneous transhepatic variceal embolization in patients with cirrhosis

Cited by 3 publications

References 31 publications

Risk factors and predictive nomograms of bedside emergency endoscopic treatment of esophagogastric variceal bleeding in cirrhotic patients with endotracheal intubation

Risk factors and predictive nomograms of bedside emergency endoscopic treatment of esophagogastric variceal bleeding in cirrhotic patients with endotracheal intubation

Risk factors and predictive nomograms for bedside emergency endoscopic treatment following endotracheal intubation in cirrhotic patients with esophagogastric variceal bleeding

Efficacy of transjugular intrahepatic portosystemic shunts in treating cirrhotic esophageal-gastric variceal bleeding

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