Validation of a decision rule to predict patients at low risk of variceal upper gastrointestinal hemorrhage

Horton, Gabriella; Barkun, Alan N.; Martel, Myriam; Klein, Lauren R.

doi:10.1016/j.ajem.2020.04.001

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…Thus, the platelet count reflects the severity of hypersplenism and portal hypertension. Platelet count is the primary parameter in the decision rules used by hospitals in Canada to predict which patients are at low risk of variceal upper gastrointestinal hemorrhage ( 26 ). In our present study, the analysis of the non-invasive predictors was based on the maximum thickness of the spleen measured in millimeters by using abdominal ultrasound, and the platelet count.…”

Section: Discussionmentioning

confidence: 99%

Platelet Count/Spleen Thickness Ratio and the Risk of Variceal Bleeding in Cirrhosis With Esophagogastric Varices

et al. 2022

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IntroductionThe platelet count/spleen thickness ratio (PC/ST ratio) is associated with the grade of esophagogastric varices (EGV) in cirrhotic patients, but little is known about its relationship with esophagogastric variceal bleeding (EGVB). The aim of this study was to investigate the association between the PC/ST ratio and the risk of EGVB within 1 year in cirrhotic patients.MethodsA total of 1,354 patients with cirrhosis who had EGV were enrolled in this cohort study. A logistic regression model was used to determine the association between the PC/ST ratio and the risk of EGVB within 1 year in patients with cirrhosis by adjusting the PC/ST ratio with all the important clinical variables and confounders.ResultsThe quartile values of the PC/ST ratio were 1.01, 1.36, and 1.98, respectively. The PC/ST ratio was an independent risk factor for variceal bleeding in cirrhotic patients with moderate or severe EGV. After adjusting for multiple variables, the relationship was still unchanged. The odds ratios of the first EGVB in these patients were 5.07-fold at non-adjustment and 3.28-fold after multivariate adjustment. The odds ratios of rebleeding in these patients from the lowest to the highest quartile were 2.34-fold at non-adjustment and 2.01-fold after multivariable adjustment. The PC/ST ratio ≤ 1.36 elevated the 1-year risk of first-time variceal bleeding or rebleeding in cirrhotic patients with moderate or severe EGV (All P < 0.05).ConclusionThe PC/ST ratio ≤ 1.36 is an independent risk factor for the onset of first bleeding or rebleeding in cirrhotic patients with moderate or severe EGV.

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Section: Discussionmentioning

confidence: 99%

Platelet Count/Spleen Thickness Ratio and the Risk of Variceal Bleeding in Cirrhosis With Esophagogastric Varices

et al. 2022

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“…Some very important indicators of liver function are ALT, AST, total protein, total bilirubin, and total bile acids. If tests of liver function result in levels of these indicators in excess of the normal ranges, impairment of liver function and higher risks of liver diseases are implied [16,17].…”

Section: Discussionmentioning

confidence: 99%

Effect of a combination of omeprazole and high-dose proton pump inhibitors on the treatment of patients with liver cirrhosis complicated with upper gastrointestinal hemorrhage

Chi¹,

Lv²,

Song³

2021

Trop. J. Pharm Res

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Purpose: To determine the effect of a combination of omeprazole and high-dose proton pump inhibitor (PPI) on the treatment of patients with liver cirrhosis complicated with upper gastrointestinal hemorrhage.Methods: A total of 100 patients with liver cirrhosis and upper gastrointestinal hemorrhage who were admitted to Qingdao Chengyang District People’s Hospital from January 2019 to September 2020 were matched and randomly assigned to a control group and a study group. Patients in both groups received a high-dose PPI treatment, while those in the study group were given omeprazole in addition to highdose PPI. Total treatment effectiveness, incidence of adverse reactions, bleeding volume, hemostasis time, liver function after treatment, Quality of Life Index (QLI) scores, Visual Analogue Scale (VAS) scores, and bleeding (%) at 1, 2 and 4 weeks after treatment were compared for the two groups of patients.Results: Omeprazole-PPI combination produced a much more favorable outcome than treatment with only high-dose PPI, in terms of effectiveness, QLI scores and liver function (p < 0.05). The study group had significantly lower incidence of adverse reactions, bleeding volume, VAS scores, and degree of bleeding at 1, 2 and 4 weeks after treatment, as well as shorter hemostasis time, than the control group (p < 0.05).Conclusion: A combination treatment of omeprazole and high-dose PPI produces better therapeutic effect than high-dose PPI alone, in patients with liver cirrhosis and upper gastrointestinal hemorrhage.

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Validation of a decision rule to predict patients at low risk of variceal upper gastrointestinal hemorrhage

Cited by 2 publications

References 12 publications

Platelet Count/Spleen Thickness Ratio and the Risk of Variceal Bleeding in Cirrhosis With Esophagogastric Varices

Platelet Count/Spleen Thickness Ratio and the Risk of Variceal Bleeding in Cirrhosis With Esophagogastric Varices

Effect of a combination of omeprazole and high-dose proton pump inhibitors on the treatment of patients with liver cirrhosis complicated with upper gastrointestinal hemorrhage

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