A fourfold increase of oesophageal variceal bleeding in cirrhotic patients with a history of oesophageal variceal bleeding.

Tsung-hsing Hung; Chih-wei Tseng; Chih-chun Tsai; Chorng-jang Lay; Chen-chi Tsai

Return

A fourfold increase of oesophageal variceal bleeding in cirrhotic patients with a history of oesophageal variceal bleeding.

Author: Tsung-Hsing HUNG ¹ ; Chih-Wei TSENG ¹ ; Chih-Chun TSAI ² ; Chorng-Jang LAY ³ ; Chen-Chi TSAI ³
Author Information

1. Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.
2. Department of Mathematics, Tamkang University, Tamsui, Taiwan.
3. School of Medicine, Tzu Chi University, Hualien, Taiwan.
Publication Type:Journal Article
Keywords: cirrhosis; epidemiology; oesophageal variceal bleeding; portal hypertension
MeSH: Adult; Aged; Alcoholism; complications; Ascites; complications; Carcinoma, Hepatocellular; complications; Databases, Factual; Diabetes Complications; Esophageal and Gastric Varices; epidemiology; etiology; Female; Gastrointestinal Hemorrhage; epidemiology; etiology; Humans; Incidence; Liver Cirrhosis; complications; physiopathology; Liver Neoplasms; complications; Male; Middle Aged; Peptic Ulcer; complications; Proportional Hazards Models; Recurrence; Retrospective Studies; Risk; Taiwan
From:Singapore medical journal 2016;57(9):511-513
CountrySingapore
Language:English
Abstract:
INTRODUCTIONLarge, recent population-based data for evaluating the predictors of oesophageal variceal bleeding (OVB) among cirrhotic patients is still lacking. This study aimed to determine the cumulative incidence of OVB among cirrhotic patients and identify the predictors of OVB occurrence.
METHODSPatient information on 38,172 cirrhotic patients without a history of OVB, who were discharged between 1 January 2007 and 31 December 2007, was obtained from the Taiwan National Health Insurance Database for this study. All patients were followed up for three years. Death was the competing risk when calculating the cumulative incidences and hazard ratios (HRs) of OVB.
RESULTSOVB was present in 2,609 patients (OVB group) and absent in 35,563 patients (non-OVB group) at hospitalisation. During the three-year follow-up period, the cumulative incidence of OVB was 44.5% and 11.3% in the OVB and non-OVB group, respectively (p < 0.001). Modified Cox regression analysis showed that the HR of OVB history was 4.42 for OVB occurrence (95% confidence interval [CI] 4.13-4.74). Other predictors for OVB occurrence included hepatocellular carcinoma (HR 1.16, 95% CI 1.09-1.24), young age (HR 0.98, 95% CI 0.98-0.98), ascites (HR 1.46, 95% CI 1.37-1.56), alcohol-related disorders (HR 1.20, 95% CI 1.12-1.28), peptic ulcer bleeding (HR 1.26, 95% CI 1.13-1.41) and diabetes mellitus (HR 1.14, 95% CI 1.06-1.23).
CONCLUSIONCirrhotic patients have a fourfold increased risk of future OVB following the first incidence of OVB.