Clinical Features and Treatment Outcomes of Upper Gastrointestinal Bleeding in Patients with Cirrhosis.
10.3346/jkms.2008.23.4.635
- Author:
Yeon Seok SEO
1
;
Youn Ho KIM
;
Sang Hoon AHN
;
Sang Kyun YU
;
Soon Koo BAIK
;
Sung Kyu CHOI
;
Jeong HEO
;
Taeho HAHN
;
Tae Woo YOO
;
Se Hyun CHO
;
Hyun Woong LEE
;
Ju Hyun KIM
;
Mong CHO
;
Sang Hoon PARK
;
Byung Ik KIM
;
Kwang Hyub HAN
;
Soon Ho UM
Author Information
1. Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. umsh@korea.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Liver Cirrhosis;
Varicose Veins;
Hemorrhage;
Hemostasis;
Prevention and Control;
Prognosis
- MeSH:
Adult;
Aged;
Cohort Studies;
Female;
Gastrointestinal Hemorrhage/mortality/*therapy;
Hemostatic Techniques;
Humans;
Infection/epidemiology;
Liver Cirrhosis/*complications;
Lysine Vasopressin/analogs & derivatives/therapeutic use;
Male;
Middle Aged;
Treatment Outcome
- From:Journal of Korean Medical Science
2008;23(4):635-643
- CountryRepublic of Korea
- Language:English
-
Abstract:
With recent progress in treatment modalities, mortality from upper gastrointestinal (UGI) bleeding has decreased appreciably. The aim of this study was to establish how UGI bleeds are managed in Korean patients with cirrhosis and to evaluate treatment outcomes. A total of 479 episodes of acute UGI bleeding in 464 patients with cirrhosis were included during a six-month period at nine tertiary medical centers. Treatment outcomes were assessed by failure to control bleeding, rebleeding and mortality. The source of bleeding was esophagogastric varices in 77.7% of patients, nonvariceal lesions in 15.9%, and undefined in 6.5%. For control of bleeding, endoscopic and pharmacologic treatments were used in 74.7% and 81.9% of patients, respectively. Variceal ligation was a major technique for endoscopic treatment (90%), and terlipressin and somatostatin were the main pharmacologic agents used (96.4%). Initial hemostasis was achieved in 86.8% of cases, but rebleeding occurred in 3.8% and 16.8% of cases within five days and six weeks of hemorrhage, respectively. Five-day and six-week mortality were 11.3% and 25.9%, respectively. Survival of patients with variceal bleeding seems to be remarkably improved than previous reports, which may suggest the advances in hemostatic methods for control of variceal hemorrhage..
