Esophageal variceal pressure is a major predictor of variceal bleeding in cirrhotic patients
10.3760/cma.j.issn.0254-1432.2009.02.005
- VernacularTitle:食管曲张静脉压力是预测肝硬化曲张静脉破裂出血的主要危险因素
- Author:
Derun KONG
;
Jianming XU
;
Lei ZHANG
;
Jiahu HAO
;
Bin SUN
- Publication Type:Journal Article
- Keywords:
Esophageal and gastric varices;
Liver cirrhosis;
Portal pressure
- From:
Chinese Journal of Digestion
2009;29(2):86-89
- CountryChina
- Language:Chinese
-
Abstract:
Objective To prospectively study the main risk factors of variceal bleeding in cirrhotic patients. Methods Fifty-seven patients with liver cirrhosis and esophageal varices who had never experienced variceal bleeding were followed up for 12 months. The patients underwent measurements of esophageal variceal pressure by non-invasive endoscopic balloon technique. The endpoint of the study was the presence of a variceal hemorrhage. The relationship between variceal hemorrhage and endoscopic findings including varices, variceal pressure, Child-Pugh status, ascites, and etiology of cirrhosis was studied. Results Thirty-four patients (59.6% ) developed a variceal hemorrhage. In univariate analysis, the level of variceal pressure (P= 0. 001), the size of varices (P=0. 006), and the endoscopic red color sign on the variceal wall (P=0. 012) predicted higher risks of variceal hemorrhage. The multiple logistic regression revealed that variceal pressure was a major predictor of the risk for a first variceal bleeding (OR=2. 817, P=0. 003). The area under the receiver operating characteristic (ROC) of variceal pressure for predicting variceal bleeding was 0. 98, and the variceal pressure cutoff value was 25.3 mm Hg (1 mm Hg=0. 133 kPa) with both specificity and sensitivity of 91 %. Conclusion The level of variceal pressure is a major predictor for variceal bleeding in cirrhotic patients.
