The effects of cefazolin on cirrhotic patients with acute variceal hemorrhage after endoscopic interventions

Xu, Huang‐Wei; Wang, Jing‐Houng; Tsai, Moan-Shane; Wu, Keng‐Liang; Chiou, Shue-Shian; Changchien, Chi‐Sin; Hu, Tsung Hui; Lu, Sheng–Nan; Chuah, Seng‐Kee

doi:10.1007/s00464-011-1642-0

Cited by 23 publications

(25 citation statements)

References 27 publications

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“…About one-third of patients with cirrhosis can experience their first episode of acute EV bleeding during follow-up, with a 70% recurrent bleeding rate and 20~50% mortality rate [1–3]. Fortunately, with recent advances in medicine and endoscopic hemostatic devices, a decrease in mortality rate has been observed over the past two decades [4–9].…”

Section: Introductionmentioning

confidence: 99%

The Role of Adjuvant Acid Suppression on the Outcomes of Bleeding Esophageal Varices after Endoscopic Variceal Ligation

Liang

Hsu

et al. 2017

PLoS ONE

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The impact of adjuvant acid suppression via proton pump inhibitors or histamine-2 receptor antagonists after endoscopic variceal ligation remains uncertain. We therefore aimed to evaluate the effect of adjuvant acid suppression on the rebleeding and mortality rates in patients who received endoscopic variceal ligation and vasoconstrictor therapy for bleeding esophageal varices. Data from 1997 to 2011 were extracted from the National Health Insurance Research Database in Taiwan. A total of 1576 cirrhotic patients aged > 18 years with a primary diagnosis of acute esophageal variceal bleeding who received endoscopic variceal ligation therapy were screened. After strict exclusion, 637 patients were recruited. The exclusion criteria included patients with gastric variceal bleeding, failure in the control of bleeding, mortality within 12 hours, and history of hepatocellular carcinoma or gastric cancer. Patients were divided into two groups: the vasoconstrictors group (n = 126) and vasoconstrictors plus acid suppression group (n = 511). We observed that the rebleeding and mortality rates were not significantly different between 2 groups during hospitalization and the 15-year follow-up period after discharge. A Charlson score ≥3 (odds ratio: 2.42, 95% confidence interval: 1.55 ~3.79, P = 0.0001), presence of hepatitis C virus (odds ratio: 1.70, 95% confidence interval: 1.15 ~2.52, P = 0.0085), and cirrhosis (odds ratio: 1.69, 95% confidence interval: 1.08 ~2.66, P = 0.0229) were the independent risk factors of mortality after discharge. In conclusion, the results of the current study suggest that adjuvant acid suppression prescription to patients who received endoscopic variceal ligation and vasoconstrictor therapy for bleeding esophageal varices may not change the rebleeding and mortality outcomes compared to that for those who received endoscopic variceal ligation and vasoconstrictor agents without acid suppression.

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Section: Introductionmentioning

confidence: 99%

The Role of Adjuvant Acid Suppression on the Outcomes of Bleeding Esophageal Varices after Endoscopic Variceal Ligation

Liang

Hsu

et al. 2017

PLoS ONE

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“…Patients with peptic ulcer bleeding were treated with intravenous high-dose PPIs (pantoprazole or esomeprazole 80 mg bolus followed by 200 mg continuous infusion for 3 days). Rebleeding was defined as a new onset of hematemesis, melena, fresh blood or coffee ground material in the nasogastric (NG) tube, or both associated with tachycardia or hypovolemic shock or a decrease in serum hemoglobin level >2 g/dL after successful endoscopic and pharmacological treatment, and hemodynamic stability of at least a 24-hour period of stable vital signs [10–12]. Bleeding recurrence was confirmed by endoscopy in all cases.…”

Section: Methodsmentioning

confidence: 99%

Outcome of Holiday and Nonholiday Admission Patients with Acute Peptic Ulcer Bleeding: A Real-World Report from Southern Taiwan

Chuah

Chang

et al. 2014

BioMed Research International

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Background. Recent findings suggest that patients admitted on the weekend with peptic ulcer bleeding might be at increased risk of adverse outcomes. However, other reports found that there was no “holiday effect.” The purpose of this study was to determine if these findings hold true for a real-life Taiwanese medical gastroenterology practice. Materials and Methods. We reviewed the medical files of hospital admissions for patients with peptic ulcer bleeding who received initial endoscopic hemostasis between January 2009 and March 2011. A total of 744 patients were enrolled (nonholiday group, n = 615; holiday group, n = 129) after applying strict exclusion criteria. Holidays were defined as weekends and national holidays in Taiwan. Results. Our results showed that there was no significant difference in baseline characteristics between the two groups. We also observed that, compared to the nonholiday group, patients in the holiday group received earlier endoscopy treatment (12.20 hours versus 16.68 hours, P = 0.005), needed less transfused blood (4.8 units versus 6.6 units, P = 0.02), shifted from intravenous to oral proton-pump inhibitors (PPIs) more quickly (5.3 days versus 6.9 days, P = 0.05), and had shorter hospital stays (13.05 days versus 17.36 days, P = 0.005). In the holiday and nonholiday groups, the rebleeding rates were 17.8% and 23.41% (P = 0.167), the mortality rates were 11.63% versus 13.66% (P = 0.537), and surgery was required in 2.11% versus 4.66% (P = 0.093), respectively. Conclusions. Patients who presented with peptic ulcer bleeding on holidays did not experience delayed endoscopy or increased adverse outcomes. In fact, patients who received endoscopic hemostasis on the holiday had shorter waiting times, needed less transfused blood, switched to oral PPIs quicker, and experienced shorter hospital stays.

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“…Among all indicators, these were chosen based on combined availability of strength of supporting evidence, measurement feasibility, and evidence of substantial variation in performance. [76][77][78] There are very limited data on practice variation for the majority of these EGD indicators, representing an important research area.…”

Section: Priority Indicators For Egdmentioning

confidence: 99%

Quality indicators for EGD

Park¹,

Shaheen

Cohen³

et al. 2015

Gastrointestinal Endoscopy

123

113

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The effects of cefazolin on cirrhotic patients with acute variceal hemorrhage after endoscopic interventions

Cited by 23 publications

References 27 publications

The Role of Adjuvant Acid Suppression on the Outcomes of Bleeding Esophageal Varices after Endoscopic Variceal Ligation

The Role of Adjuvant Acid Suppression on the Outcomes of Bleeding Esophageal Varices after Endoscopic Variceal Ligation

Outcome of Holiday and Nonholiday Admission Patients with Acute Peptic Ulcer Bleeding: A Real-World Report from Southern Taiwan

Quality indicators for EGD

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